Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 251373 | MA |
N | 207R00000X | Internist | 00000000 | IL |
N | 111NI0900X | Internist | 00000000 | IL |
NPI | 1376876565 |
---|---|
Provider Name | Lakiea Wright |
First Address | Buzzards Bay, MA 02532-3270 |
Second Address | Buzzards Bay, MA 02532-3270 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2009 |
Last Update Date | 31/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110096022A | (05) | MA |