Provider Demographics
NPI:1730792185
Name:WRIGHT, CHARLOTTE LOUISE (APRN)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:LOUISE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 GS RICHARDS BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-8462
Mailing Address - Country:US
Mailing Address - Phone:702-202-4776
Mailing Address - Fax:
Practice Address - Street 1:3475 GS RICHARDS BLVD STE 130
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-8462
Practice Address - Country:US
Practice Address - Phone:775-841-2000
Practice Address - Fax:775-841-4200
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV838022363L00000X, 207W00000X
PASP022370363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1730792185Medicaid