Provider Demographics
NPI:1568943942
Name:WRIGHT, JENNIFER A (APRN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:13140 LAUREL LEAF DR
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-9620
Mailing Address - Country:US
Mailing Address - Phone:603-254-5376
Mailing Address - Fax:
Practice Address - Street 1:16337 COASTAL HWY
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-3607
Practice Address - Country:US
Practice Address - Phone:302-291-9900
Practice Address - Fax:302-200-9094
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH052105-23363LF0000X
DELG0012546363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3114532Medicaid
VT1034073Medicaid