Provider Demographics
NPI:1558466102
Name:WRIGHT, JILL CATHERINE (MD)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:CATHERINE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5613 CALTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612
Mailing Address - Country:US
Mailing Address - Phone:919-420-0236
Mailing Address - Fax:
Practice Address - Street 1:2620 NEW BERN AVENUE
Practice Address - Street 2:NEW BERN RIDGE PEDIATRICS
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:919-231-3180
Practice Address - Fax:919-231-8077
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701664208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891105CMedicaid
NC1782871OtherUNITED HEALTH CARE
NC1105COtherBLUE CROSS BLUE SHIELD
NC218891OtherWELL PATH
NC5356993OtherCIGNA
G63720Medicare UPIN