Provider Demographics
NPI:1568464626
Name:WRIGHT, JENNIFER CARNES (FNP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:CARNES
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:ELLIS
Other - Last Name:CARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, FNP
Mailing Address - Street 1:49 HOOPER ST
Mailing Address - Street 2:
Mailing Address - City:WISCASSET
Mailing Address - State:ME
Mailing Address - Zip Code:04578-4053
Mailing Address - Country:US
Mailing Address - Phone:207-882-7911
Mailing Address - Fax:207-882-6178
Practice Address - Street 1:49 HOOPER ST
Practice Address - Street 2:
Practice Address - City:WISCASSET
Practice Address - State:ME
Practice Address - Zip Code:04578-4053
Practice Address - Country:US
Practice Address - Phone:207-882-7911
Practice Address - Fax:207-882-6178
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER044235363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME2596000099 / 1019800Medicaid
ME047672OtherANTHEM BC BS
ME2596000099 / 1019800Medicaid
MEUX5097Medicare PIN