Provider Demographics
NPI:1831375203
Name:WRIGHT, DONNA V (NP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:V
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:V
Other - Last Name:DELOACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:8311 WARREN H ABERNATHY HWY
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-1249
Practice Address - Country:US
Practice Address - Phone:864-562-5102
Practice Address - Fax:864-562-5230
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1960363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0746Medicaid
SCSCB7216067OtherMEDICARE PIN
SCNP0746Medicaid