Provider Demographics
NPI:1962213579
Name:WRIGHT, IDA MARIE
Entity type:Individual
Prefix:
First Name:IDA
Middle Name:MARIE
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 1:1054 MOUND ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45203-1458
Mailing Address - Country:US
Mailing Address - Phone:513-578-2335
Mailing Address - Fax:
Practice Address - Street 1:1164 WAYCROSS RD APT A316
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3044
Practice Address - Country:US
Practice Address - Phone:513-903-2038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide