Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 01060585A | IN |
NPI | 1073501136 |
---|---|
Provider Name | Katrina E Wright |
First Address | Oak Brook, IL 60523-1563 |
Second Address | Merrillville, IN 46410-7086 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 13/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000362521 | BL SHIELD (01) | IN |
100082060 | (05) | IN |
I41724 | (02) | IN |