Provider Demographics
NPI:1124332861
Name:WRIGHT, KIMBERLY (ARNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:ARNP
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 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-272-5135
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:150 FRANKFORT RD STE 103
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-7401
Practice Address - Country:US
Practice Address - Phone:502-844-2888
Practice Address - Fax:502-394-3650
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6620P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner