Provider Demographics
NPI:1457643694
Name:WRIGHT-MALEY, JENNIFER L (MSN, MPH, CNM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:WRIGHT-MALEY
Suffix:
Gender:F
Credentials:MSN, MPH, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 METHYL ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4901
Mailing Address - Country:US
Mailing Address - Phone:805-689-2956
Mailing Address - Fax:
Practice Address - Street 1:31 METHYL ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4901
Practice Address - Country:US
Practice Address - Phone:805-689-2956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-06
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICMW00134367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife