Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | APRN 775 | HI |
NPI | 1033273412 |
---|---|
Provider Name | Mrs. Ellen J Wright |
First Address | Henderson, NV 89052-8507 |
Second Address | Las Vegas, NV 89119-6795 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 24/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A0250470 | HMSA (01) | HI |