Provider Demographics
NPI:1134202773
Name:WRIGHT, TONIA R (APRN-CRNA)
Entity type:Individual
Prefix:
First Name:TONIA
Middle Name:R
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:APRN-CRNA
Other - Prefix:
Other - First Name:TONIA
Other - Middle Name:R
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3200 MACCORKLE AVE SE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1227
Mailing Address - Country:US
Mailing Address - Phone:304-388-5559
Mailing Address - Fax:
Practice Address - Street 1:3200 MACCORKLE LANE
Practice Address - Street 2:CAMC MEM DIVISION
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304
Practice Address - Country:US
Practice Address - Phone:304-388-4077
Practice Address - Fax:304-388-9852
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN42831-CRNA367500000X
WV046512367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV430070392OtherR MEDICARE
WV0068614000Medicaid