Provider Demographics
NPI:1699476820
Name:WRIGHT, MELISSA ROCHELLE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ROCHELLE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 N IRON HORSE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE POINT
Mailing Address - State:UT
Mailing Address - Zip Code:84074-3494
Mailing Address - Country:US
Mailing Address - Phone:916-320-5625
Mailing Address - Fax:
Practice Address - Street 1:5169 S COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6767
Practice Address - Country:US
Practice Address - Phone:801-507-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11690370-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner