Provider Demographics
NPI:1194563502
Name:WRIGHT, MAKAYLIA DAWN
Entity type:Individual
Prefix:
First Name:MAKAYLIA
Middle Name:DAWN
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 1:2008 THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-3331
Mailing Address - Country:US
Mailing Address - Phone:220-710-5620
Mailing Address - Fax:
Practice Address - Street 1:1719 HUTCHINS
Practice Address - Street 2:N/A
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3135
Practice Address - Country:US
Practice Address - Phone:740-357-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty