Provider Demographics
NPI:1811498694
Name:WRIGHT, TELA MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:TELA
Middle Name:MICHELLE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8184 KILWINNING LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-5517
Mailing Address - Country:US
Mailing Address - Phone:904-715-0391
Mailing Address - Fax:
Practice Address - Street 1:7855 ARGYLE FOREST BLVD STE 703
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-7705
Practice Address - Country:US
Practice Address - Phone:904-715-0391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9383901163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health