Provider Demographics
NPI:1881263119
Name:WRIGHT, INDIA VONSHEA
Entity type:Individual
Prefix:
First Name:INDIA
Middle Name:VONSHEA
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8290 STRASBURG RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6857
Mailing Address - Country:US
Mailing Address - Phone:404-493-9802
Mailing Address - Fax:
Practice Address - Street 1:8290 STRASBURG RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6857
Practice Address - Country:US
Practice Address - Phone:404-493-9802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL333534374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide