Provider Demographics
NPI:1457199358
Name:WRIGHT, MARLEE (PA)
Entity type:Individual
Prefix:MRS
First Name:MARLEE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26150 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:TN
Mailing Address - Zip Code:38449-3158
Mailing Address - Country:US
Mailing Address - Phone:312-029-2979
Mailing Address - Fax:
Practice Address - Street 1:26150 MAIN ST
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:TN
Practice Address - Zip Code:38449-3158
Practice Address - Country:US
Practice Address - Phone:312-029-2979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6340363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant