Provider Demographics
NPI:1619956083
Name:WRIGHT, REGINA L (ANP)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375N CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2306
Mailing Address - Country:US
Mailing Address - Phone:520-838-2117
Mailing Address - Fax:520-838-2260
Practice Address - Street 1:445N SILVERBELL RD 200
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2686
Practice Address - Country:US
Practice Address - Phone:520-624-8935
Practice Address - Fax:520-624-0053
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN-049454363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ343327Medicaid
103640Medicare ID - Type Unspecified
AZ343327Medicaid