Provider Demographics
NPI:1609801166
Name:JURICH-WRIGHT, PAMELA R (CNM)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:R
Last Name:JURICH-WRIGHT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:JURICH
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:905 CULVER RD
Mailing Address - Street 2:STE 2B
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-7115
Mailing Address - Country:US
Mailing Address - Phone:585-275-7892
Mailing Address - Fax:585-482-1666
Practice Address - Street 1:905 CULVER RD
Practice Address - Street 2:STE 2B
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-7115
Practice Address - Country:US
Practice Address - Phone:585-275-7892
Practice Address - Fax:585-482-1666
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000676367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01827921Medicaid
P02060Medicare UPIN
NYRB1905-GRP:BA0017Medicare PIN
NYRB0608-GRP:70008AMedicare PIN
NY01827921Medicaid