Provider Demographics
NPI:1043961485
Name:WRIGHT, DORRIS ANN
Entity type:Individual
Prefix:
First Name:DORRIS
Middle Name:ANN
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 1:13700 58TH ST N STE 209
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-3757
Mailing Address - Country:US
Mailing Address - Phone:727-223-3545
Mailing Address - Fax:
Practice Address - Street 1:13700 58TH ST N BLDG 2
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3757
Practice Address - Country:US
Practice Address - Phone:727-223-3545
Practice Address - Fax:727-223-3785
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL444201164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse