Provider Demographics
NPI:1861890774
Name:WRIGHT, DANIELLE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
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 1:7700 WOODLAND AVE
Mailing Address - Street 2:APT.K2
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104-3069
Mailing Address - Country:US
Mailing Address - Phone:216-563-2212
Mailing Address - Fax:
Practice Address - Street 1:7700 WOODLAND AVE
Practice Address - Street 2:K2
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-3069
Practice Address - Country:US
Practice Address - Phone:216-563-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTJ786730163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH123456Medicaid