Provider Demographics
NPI:1831749910
Name:WRIGHT, KATHY L
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 266
Mailing Address - Street 2:
Mailing Address - City:GOODHUE
Mailing Address - State:MN
Mailing Address - Zip Code:55027
Mailing Address - Country:US
Mailing Address - Phone:507-993-9987
Mailing Address - Fax:
Practice Address - Street 1:107 N 5TH ST
Practice Address - Street 2:
Practice Address - City:GOODHUE
Practice Address - State:MN
Practice Address - Zip Code:55027
Practice Address - Country:US
Practice Address - Phone:507-993-9987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider