Provider Demographics
NPI:1134532989
Name:WRIGHT, WANDA (LPN)
Entity type:Individual
Prefix:MS
First Name:WANDA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:WANDA
Other - Middle Name:FINCH
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:389 COUNTY HIGHWAY 3
Mailing Address - Street 2:
Mailing Address - City:MARGARETVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12455
Mailing Address - Country:US
Mailing Address - Phone:845-586-2308
Mailing Address - Fax:
Practice Address - Street 1:389 COUNTY HIGHWAY 3
Practice Address - Street 2:
Practice Address - City:MARGARETVILLE
Practice Address - State:NY
Practice Address - Zip Code:12455-2712
Practice Address - Country:US
Practice Address - Phone:845-586-2308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302043164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse