Provider Demographics
NPI:1912788548
Name:WRIGHT, JONET CHABRE'
Entity Type:Individual
Prefix:
First Name:JONET
Middle Name:CHABRE'
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 1:1500 RUSSELL LEE DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40211-4308
Mailing Address - Country:US
Mailing Address - Phone:502-804-6459
Mailing Address - Fax:
Practice Address - Street 1:1500 RUSSELL LEE DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40211-4308
Practice Address - Country:US
Practice Address - Phone:502-804-6459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
146D00000X
KY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant