Provider Demographics
NPI:1134892391
Name:WRIGHT, KIMBERLY S (CERTIFIED PHLEBOTOMI)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:S
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CERTIFIED PHLEBOTOMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 N 14TH ST
Mailing Address - Street 2:
Mailing Address - City:CHARITON
Mailing Address - State:IA
Mailing Address - Zip Code:50049-1631
Mailing Address - Country:US
Mailing Address - Phone:515-771-4487
Mailing Address - Fax:
Practice Address - Street 1:310 N HOWARD ST
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-1842
Practice Address - Country:US
Practice Address - Phone:641-871-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-25
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA8411578678867246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory