Individual
MS. TINA M WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2418 CURTIS DR, SUITE B, WINAMAC, IN 46996-8818
(574) 946-7900
(574) 946-7936
Mailing address
2418 CURTIS DR, SUITE B, WINAMAC, IN 46996-8818
(574) 946-7900
(574) 946-7936
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001001A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001041077
ANTHEM BLUE CROSS AND BLUE SHIELD
IN
05
—
200355410A
—
IN
Enumeration date
08/03/2005
Last updated
12/07/2016
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