Provider Demographics
NPI:1457162646
Name:WRIGHT, AURORA RAYE
Entity type:Individual
Prefix:
First Name:AURORA
Middle Name:RAYE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AURORA
Other - Middle Name:
Other - Last Name:BAMISILE, KNAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5458 JUSTICE DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-9022
Mailing Address - Country:US
Mailing Address - Phone:763-412-0743
Mailing Address - Fax:
Practice Address - Street 1:1202 WESTRAC DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-2338
Practice Address - Country:US
Practice Address - Phone:701-280-9545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care