Provider Demographics
NPI:1861179970
Name:WRIGHT, ALYSSA LOUISE
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LOUISE
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 1:10 CATAWBA LN
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:WV
Mailing Address - Zip Code:26184-7166
Mailing Address - Country:US
Mailing Address - Phone:304-844-7168
Mailing Address - Fax:
Practice Address - Street 1:417 GRAND PARK DR STE 203
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26105-4049
Practice Address - Country:US
Practice Address - Phone:304-424-9293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV40994164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse