Provider Demographics
NPI:1467513010
Name:WRIGHT, WANDA SUE (RN)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:SUE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:WANDA
Other - Middle Name:S
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 3216
Mailing Address - Street 2:301 WRIGHT AVENUE
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293-3216
Mailing Address - Country:US
Mailing Address - Phone:276-328-1729
Mailing Address - Fax:276-328-1729
Practice Address - Street 1:301 WRIGHT AVENUE
Practice Address - Street 2:
Practice Address - City:WISE
Practice Address - State:VA
Practice Address - Zip Code:24293-3216
Practice Address - Country:US
Practice Address - Phone:276-328-1729
Practice Address - Fax:276-328-1729
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001167905163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse