Provider Demographics
NPI:1942414297
Name:WRIGHT, STEPHANIE K (FNP, PNP)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:K
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:FNP, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 WATTS BRANCH PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2913
Mailing Address - Country:US
Mailing Address - Phone:301-279-8843
Mailing Address - Fax:301-309-0914
Practice Address - Street 1:8 W MIDDLE LN
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2213
Practice Address - Country:US
Practice Address - Phone:301-468-6483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR070604363LP0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1E10-QW3-TK90Medicaid
MD190891000Medicaid