Provider Demographics
NPI:1649400987
Name:WRIGHT, AMY (RD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-0449
Mailing Address - Country:US
Mailing Address - Phone:765-529-4403
Mailing Address - Fax:765-593-2510
Practice Address - Street 1:615 STATE ROAD 38 W
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362
Practice Address - Country:US
Practice Address - Phone:765-529-4403
Practice Address - Fax:765-593-2510
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN00948571133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered