Provider Demographics
NPI:1639378375
Name:WRIGHT, BETTY MOELLER (RPH)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:MOELLER
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2833 EMSLIE DR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1392
Mailing Address - Country:US
Mailing Address - Phone:262-896-9692
Mailing Address - Fax:
Practice Address - Street 1:2833 EMSLIE DR
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1392
Practice Address - Country:US
Practice Address - Phone:262-896-9692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIR9180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist