Provider Demographics
NPI:1649924309
Name:WRIGHT, MICHELLE TIFFANY (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:TIFFANY
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 MOHAWK TRCE
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-7322
Mailing Address - Country:US
Mailing Address - Phone:314-425-9441
Mailing Address - Fax:
Practice Address - Street 1:16555 MACHESTER RD
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63040
Practice Address - Country:US
Practice Address - Phone:314-458-0646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021045606363LF0000X
MO2017006081163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse