Provider Demographics
NPI:1942253745
Name:WRIGHT, JENNIFER PUGH (CRNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PUGH
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8404 MORPHY AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-3690
Mailing Address - Country:US
Mailing Address - Phone:251-786-1331
Mailing Address - Fax:251-964-4012
Practice Address - Street 1:1083 E RELHAM AVE
Practice Address - Street 2:
Practice Address - City:LOXLEY
Practice Address - State:AL
Practice Address - Zip Code:36551-2406
Practice Address - Country:US
Practice Address - Phone:251-964-4011
Practice Address - Fax:251-964-4012
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1076359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51532895OtherBLUECROSS BLUESHIELD