Provider Demographics
NPI:1962028258
Name:WRIGHT, KATHRYN CHRISTINE (FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:CHRISTINE
Last Name:WRIGHT
Suffix:
Gender:
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 1:1020 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE ODESSA
Mailing Address - State:MI
Mailing Address - Zip Code:48849-1004
Mailing Address - Country:US
Mailing Address - Phone:616-374-8881
Mailing Address - Fax:616-374-4220
Practice Address - Street 1:1020 4TH AVE
Practice Address - Street 2:
Practice Address - City:LAKE ODESSA
Practice Address - State:MI
Practice Address - Zip Code:48849-1004
Practice Address - Country:US
Practice Address - Phone:616-374-8881
Practice Address - Fax:616-374-4220
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704339804363LP2300X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse