Provider Demographics
NPI:1073670683
Name:WRIGHT, JANICE LEA (LPN)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:LEA
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 W CORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:NY
Mailing Address - Zip Code:13073-1011
Mailing Address - Country:US
Mailing Address - Phone:607-280-4692
Mailing Address - Fax:
Practice Address - Street 1:275 CHIPMAN CORNERS RD
Practice Address - Street 2:
Practice Address - City:LOCKE
Practice Address - State:NY
Practice Address - Zip Code:13092-3134
Practice Address - Country:US
Practice Address - Phone:607-898-3638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160568-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse