Provider Demographics
NPI:1730606849
Name:WRIGHT, ALICIA N (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:N
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PINE ST STE 175
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-2606
Mailing Address - Country:US
Mailing Address - Phone:616-748-6060
Mailing Address - Fax:
Practice Address - Street 1:100 PINE ST STE 175
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-2606
Practice Address - Country:US
Practice Address - Phone:616-748-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI163W00000X363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily