Provider Demographics
NPI:1285079061
Name:WRIGHT, CARL A (NP)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:A
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7845 SPRING ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:SPRING ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49283-9785
Mailing Address - Country:US
Mailing Address - Phone:517-750-3038
Mailing Address - Fax:517-750-3482
Practice Address - Street 1:7845 SPRING ARBOR RD
Practice Address - Street 2:
Practice Address - City:SPRING ARBOR
Practice Address - State:MI
Practice Address - Zip Code:49283-9785
Practice Address - Country:US
Practice Address - Phone:517-750-3038
Practice Address - Fax:517-750-3482
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704269523363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner