Provider Demographics
NPI:1902414592
Name:WRIGHT, MOLLY NICOLE (MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:NICOLE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:MS
Other - First Name:MOLLY
Other - Middle Name:NICOLE
Other - Last Name:FAST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:8328 NW 140TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-4006
Mailing Address - Country:US
Mailing Address - Phone:405-202-9341
Mailing Address - Fax:
Practice Address - Street 1:551 SE 4TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-6790
Practice Address - Country:US
Practice Address - Phone:405-703-9321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK117287207Q00000X, 363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner