Provider Demographics
NPI:1982007795
Name:WRIGHT, JESSICA (CNP,DNP)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CNP,DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NM
Mailing Address - Zip Code:88415-3304
Mailing Address - Country:US
Mailing Address - Phone:575-374-2585
Mailing Address - Fax:575-374-8146
Practice Address - Street 1:300 WILSON ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NM
Practice Address - Zip Code:88415-3304
Practice Address - Country:US
Practice Address - Phone:575-374-2585
Practice Address - Fax:575-374-8146
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP02522363LF0000X, 363LF0000X
TXAP132047363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily