Doctor Name: | DR. JESSICA ANN WRIGHT |
NPI Number: | 1205064458 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DO |
License Number: | 5101018464 |
Business Practice Address: | 125 S Kalamazoo Mall Suite 204 Kalamazoo, MI - 490074832 |
Business Phone Number: | 2693433900 |
Business Fax Number: | |
Mailing Address: | 125 South Kalamazoo Mall, Suite 204 KALAMAZOO |
State: | MI |
Postal Code: | 49007 |
Phone Number: | 2693433900 |
Fax Number: | |
NPI Enumeration Date: | 06/26/2009 |
NPI Last Update Date: | 09/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 5101018464 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |