Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 3847P | KY |
NPI | 1013000579 |
---|---|
Provider Name | Bessie Ellen Wright |
First Address | Whitesburg, KY 41858 |
Second Address | Whitesburg, KY 41858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |