Provider Demographics
NPI:1306364526
Name:WRIGHT, KELLY KARELL (AGNP)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:KARELL
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:ANNE
Other - Last Name:KARELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:180 EVERETT YOPP DR
Mailing Address - Street 2:
Mailing Address - City:SNEADS FERRY
Mailing Address - State:NC
Mailing Address - Zip Code:28460-9446
Mailing Address - Country:US
Mailing Address - Phone:205-422-4742
Mailing Address - Fax:
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1231
Practice Address - Country:US
Practice Address - Phone:919-231-9623
Practice Address - Fax:919-350-8333
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016451363L00000X, 363LA2200X, 363LG0600X
AL1-128114363LG0600X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health