Provider Demographics
NPI:1588961213
Name:WRIGHT, EMILY LYNNANNE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:LYNNANNE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 S CITY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:STIGLER
Mailing Address - State:OK
Mailing Address - Zip Code:74462-3113
Mailing Address - Country:US
Mailing Address - Phone:918-408-0147
Mailing Address - Fax:
Practice Address - Street 1:1601 S CITY LAKE RD
Practice Address - Street 2:
Practice Address - City:STIGLER
Practice Address - State:OK
Practice Address - Zip Code:74462-3113
Practice Address - Country:US
Practice Address - Phone:918-408-0147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist