Provider Demographics
NPI:1447831797
Name:WRIGHT, KYISHA (RN)
Entity type:Individual
Prefix:
First Name:KYISHA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1043 BUCKHORN BND
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-3449
Mailing Address - Country:US
Mailing Address - Phone:404-219-8832
Mailing Address - Fax:470-412-6027
Practice Address - Street 1:1043 BUCKHORN BND
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-3449
Practice Address - Country:US
Practice Address - Phone:404-219-8832
Practice Address - Fax:470-412-6027
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN278774163WH0500X, 163WH1000X, 163WW0000X, 163WX1500X, 163WH0200X
251E00000X, 251G00000X, 251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysisGroup - Multi-Specialty
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy CareGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care