Basic Information
| Provider Information | |||||||||
| NPI: | 1205351830 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2029 N 75 E | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 475017626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124866639 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5066 N 900 E | ||||||||
| Address2: | |||||||||
| City: | MONTGOMERY | ||||||||
| State: | IN | ||||||||
| PostalCode: | 475585790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124863396 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2017 | ||||||||
| LastUpdateDate: | 08/04/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | 28160792A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No ID Information.