Provider Demographics
NPI:1457836694
Name:WRIGHT, AMY NICHOLSON (RDN, LD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:NICHOLSON
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RDN, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 HILL ST STE 111
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-2792
Mailing Address - Country:US
Mailing Address - Phone:936-635-8040
Mailing Address - Fax:
Practice Address - Street 1:503 HILL ST STE 111
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-2792
Practice Address - Country:US
Practice Address - Phone:936-635-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05415133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered