Doctor Name: | VERONICA N WRIGHT |
NPI Number: | 1043637051 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 041370660 |
Business Practice Address: | 144 Dettro Dr Mattoon, IL - 619389012 |
Business Phone Number: | 2172383000 |
Business Fax Number: | |
Mailing Address: | 1005 Health Center Dr, Suite 202 MATTOON |
State: | IL |
Postal Code: | 619384693 |
Phone Number: | 2172582414 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2014 |
NPI Last Update Date: | 03/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 041370660 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |