Provider Demographics
NPI:1649234105
Name:WRIGHT, JANET RAE (CNP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:RAE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:JAN
Other - Middle Name:RAE
Other - Last Name:INTVELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-4533
Mailing Address - Fax:605-328-4531
Practice Address - Street 1:5019 S WESTERN AVE STE 200
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5155
Practice Address - Country:US
Practice Address - Phone:605-328-9700
Practice Address - Fax:605-328-9701
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000438363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDP00350991Medicare PIN
SDQ50548Medicare PIN
SDQ50548Medicare UPIN
SDS100861Medicare PIN
SDS100847Medicare PIN