1720147143 NPI number — MR. MITCHELL PAUL WRIGHT JR. R.N.

Table of content: MR. MITCHELL PAUL WRIGHT JR. R.N. (NPI 1720147143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720147143 NPI number — MR. MITCHELL PAUL WRIGHT JR. R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WRIGHT
Provider First Name:
MITCHELL
Provider Middle Name:
PAUL
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
R.N.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720147143
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7263 E MINGUS TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRESCOTT VALLEY
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
86314-9766
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
928-775-6967
Provider Business Mailing Address Fax Number:
928-442-8737

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7700 E FLORENTINE RD
Provider Second Line Business Practice Location Address:
YAVAPAI REGIONAL MEDICAL CENTER, EAST CAMPUS
Provider Business Practice Location Address City Name:
PRESCOTT VALLEY
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86314-2245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-442-8732
Provider Business Practice Location Address Fax Number:
928-442-8737
Provider Enumeration Date:
12/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN103998 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com