Provider Demographics
NPI:1497452320
Name:WRIGHT, TIMBER LEA (FNP)
Entity Type:Individual
Prefix:
First Name:TIMBER
Middle Name:LEA
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1182 E CANEY LOOP
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:TX
Mailing Address - Zip Code:75936-6021
Mailing Address - Country:US
Mailing Address - Phone:936-635-6050
Mailing Address - Fax:
Practice Address - Street 1:1501 E LOOP 304 STE 50
Practice Address - Street 2:
Practice Address - City:CROCKETT
Practice Address - State:TX
Practice Address - Zip Code:75835-3419
Practice Address - Country:US
Practice Address - Phone:936-544-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1110110363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily