Provider Demographics
NPI:1972179117
Name:WRIGHT, NATASHA ANNE
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:ANNE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:959 PALO ALTO ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-7690
Mailing Address - Country:US
Mailing Address - Phone:559-901-9864
Mailing Address - Fax:
Practice Address - Street 1:262 N HIGHWAY 65
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:CA
Practice Address - Zip Code:93247-2702
Practice Address - Country:US
Practice Address - Phone:559-562-4404
Practice Address - Fax:559-562-1685
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130739183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician