Provider Demographics
NPI:1386871192
Name:WRIGHT, KIANN LEE (MHPP)
Entity type:Individual
Prefix:MRS
First Name:KIANN
Middle Name:LEE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:KIANN
Other - Middle Name:LEE
Other - Last Name:GILLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1815 PLEASANT GROVE ROAD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404
Mailing Address - Country:US
Mailing Address - Phone:870-933-6886
Mailing Address - Fax:870-933-9395
Practice Address - Street 1:1425 W. MAIN
Practice Address - Street 2:
Practice Address - City:WALNUT RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72476
Practice Address - Country:US
Practice Address - Phone:870-886-5303
Practice Address - Fax:870-886-7002
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator