Provider Demographics
NPI:1790334019
Name:WRIGHT, BRIANNA MICHELE (RN, FNP)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MICHELE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 QUEENSBURY LN UNIT 16
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-4186
Mailing Address - Country:US
Mailing Address - Phone:831-402-8360
Mailing Address - Fax:
Practice Address - Street 1:691 MURPHY RD STE 107
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4311
Practice Address - Country:US
Practice Address - Phone:541-789-5121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201907994NP-PP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner