Provider Demographics
NPI:1437636180
Name:WRIGHT, AMY LYN (RN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:LYN
Other - Last Name:COPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1235 CARLA ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-1248
Mailing Address - Country:US
Mailing Address - Phone:319-899-0604
Mailing Address - Fax:
Practice Address - Street 1:1235 CARLA ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-1248
Practice Address - Country:US
Practice Address - Phone:319-899-0604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX841324163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA$$$$$$$$$OtherSOCIAL SECURITY