Provider Demographics
NPI:1578922811
Name:WRIGHT, TIARA (PNP)
Entity Type:Individual
Prefix:
First Name:TIARA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 N CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2422
Mailing Address - Country:US
Mailing Address - Phone:931-526-6100
Mailing Address - Fax:931-526-6002
Practice Address - Street 1:881 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5257
Practice Address - Country:US
Practice Address - Phone:931-645-4685
Practice Address - Fax:931-245-2117
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20015363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics