Provider Demographics
NPI:1679909824
Name:WRIGHT, CHELSEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5621 N LARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-5972
Mailing Address - Country:US
Mailing Address - Phone:208-871-5446
Mailing Address - Fax:
Practice Address - Street 1:5621 N LARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-5972
Practice Address - Country:US
Practice Address - Phone:208-871-5446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist