Provider Demographics
NPI:1467967885
Name:WRIGHT, TAYA DENISE
Entity Type:Individual
Prefix:
First Name:TAYA
Middle Name:DENISE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 KENILWORTH TER NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-1924
Mailing Address - Country:US
Mailing Address - Phone:202-847-9874
Mailing Address - Fax:
Practice Address - Street 1:600 KENILWORTH TER NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1924
Practice Address - Country:US
Practice Address - Phone:202-847-9874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC00703623448Medicaid