Provider Demographics
NPI:1518582287
Name:WRIGHT, LISA (APRN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:APRN
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:ATTN SHMG HPE
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-475-1575
Mailing Address - Fax:850-416-2118
Practice Address - Street 1:5153 N 9TH AVE
Practice Address - Street 2:PEDIATRIC OFFICE BUILDING
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8785
Practice Address - Country:US
Practice Address - Phone:850-416-1575
Practice Address - Fax:850-416-2118
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005476363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics