Provider Demographics
NPI:1720479223
Name:WRIGHT, KELLY BETH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:BETH
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:KELLY
Other - Middle Name:BETH
Other - Last Name:MOSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9662
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72033-9662
Mailing Address - Country:US
Mailing Address - Phone:501-852-1363
Mailing Address - Fax:501-852-1364
Practice Address - Street 1:2200 ADA AVE STE 201
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-4984
Practice Address - Country:US
Practice Address - Phone:501-852-1360
Practice Address - Fax:501-552-5316
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004299363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care