Basic Information
| Provider Information | |||||||||
| NPI: | 1972684918 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | HEIDI | ||||||||
| MiddleName: | HERMANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MBA OTR CHT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2727 E 86TH STREET | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172571556 | ||||||||
| FaxNumber: | 3172571554 | ||||||||
| Practice Location | |||||||||
| Address1: | 2727 E 86TH STREET | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172571556 | ||||||||
| FaxNumber: | 3172571554 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 225100000X | 05005386A | IN | X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225X00000X | 31000158A | IN | X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 0324030002 | 01 | IN | DMERC | OTHER | P00231179 | 01 | IN | R R MEDICARE | OTHER |