Provider Demographics
NPI:1255979191
Name:WRIGHT, HOLLY M (NP-C)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:M
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5546
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-5546
Mailing Address - Country:US
Mailing Address - Phone:801-475-3500
Mailing Address - Fax:801-475-3414
Practice Address - Street 1:1916 N 700 W STE 250
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5723
Practice Address - Country:US
Practice Address - Phone:801-479-0312
Practice Address - Fax:801-479-3364
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT283139-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1255979191Medicaid