Basic Information
| Provider Information | |||||||||
| NPI: | 1558027425 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | AGAC-NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 667 KINGSBOROUGH SQ STE 101 | ||||||||
| Address2: | |||||||||
| City: | CHESAPEAKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 233204999 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3216168131 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 MEDICAL PKWY FL 2 | ||||||||
| Address2: | |||||||||
| City: | CHESAPEAKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 233200302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7573124047 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2021 | ||||||||
| LastUpdateDate: | 11/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | 00241838061 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.