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Individual
COLLEEN KELLY WRIGHT
Active
Individual
COLLEEN KELLY WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101035828
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05607388
—
VA
01
—
080156029
RR MEDICARE
—
05
—
5611792
—
VA
Enumeration date
08/30/2005
Last updated
10/25/2012
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