Provider Demographics
NPI:1770542623
Name:WRIGHT, NANNETTE LYNN (RN, MSN, ANP-C)
Entity type:Individual
Prefix:
First Name:NANNETTE
Middle Name:LYNN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RN, MSN, ANP-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 823853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75382-3853
Mailing Address - Country:US
Mailing Address - Phone:214-215-0845
Mailing Address - Fax:
Practice Address - Street 1:8230 WALNUT HILL LN STE 220
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4425
Practice Address - Country:US
Practice Address - Phone:214-750-3646
Practice Address - Fax:214-692-8175
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX553536363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1769184Medicaid
Q57653Medicare UPIN
TX1769184Medicaid