Provider Demographics
NPI:1821354275
Name:WRIGHT, JAMES GREGORY (RN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GREGORY
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 E NIZHONI BLVD
Mailing Address - Street 2:BUILDING 4010
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-5748
Mailing Address - Country:US
Mailing Address - Phone:505-726-8609
Mailing Address - Fax:505-722-1650
Practice Address - Street 1:516 E NIZHONI BLVD
Practice Address - Street 2:BUILDING 4010
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5748
Practice Address - Country:US
Practice Address - Phone:505-726-8609
Practice Address - Fax:505-722-1650
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR64989163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care