Provider Demographics
NPI:1063696888
Name:WRIGHT, JENNIFER ANN (HOME HEALTH AIDE)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2334
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-5134
Mailing Address - Country:US
Mailing Address - Phone:740-696-0061
Mailing Address - Fax:
Practice Address - Street 1:2760 SARGENT RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-5134
Practice Address - Country:US
Practice Address - Phone:740-696-0061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2382710Medicaid