Provider Demographics
NPI:1669614301
Name:WRIGHT, ELLEN JOYCE (RN)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:JOYCE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:JOYCE
Other - Last Name:BLAKESLEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:HC 81 BOX 265C
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-9544
Mailing Address - Country:US
Mailing Address - Phone:304-667-1067
Mailing Address - Fax:
Practice Address - Street 1:HC 81 BOX 265C
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-9544
Practice Address - Country:US
Practice Address - Phone:304-667-1067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV36483163W00000X
VA0001181606163W00000X
KSUNKNOWN163W00000X
MOUNKNOWN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse