Provider Demographics
NPI:1316719677
Name:WRIGHT, KIMBERLY A (BSN RN)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:A
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MILL ST
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:NY
Mailing Address - Zip Code:12917-2200
Mailing Address - Country:US
Mailing Address - Phone:518-317-0873
Mailing Address - Fax:
Practice Address - Street 1:125 FINNEY BLVD
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1067
Practice Address - Country:US
Practice Address - Phone:518-481-8160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY756069163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse