Basic Information
Provider Information
NPI: 1215485867
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WRIGHT
FirstName: AYESHIA
MiddleName: IKEYA
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 60447
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282600447
CountryCode: US
TelephoneNumber: 7043849437
FaxNumber:  
Practice Location
Address1: 2000 WELLNESS BLVD STE 130
Address2:  
City: MONROE
State: NC
PostalCode: 281103354
CountryCode: US
TelephoneNumber: 7043162154
FaxNumber: 7043162159
Other Information
ProviderEnumerationDate: 09/12/2016
LastUpdateDate: 09/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XF0916359NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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