Individual
MAKENNA WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
(573) 334-4822
Mailing address
1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2015028834
MO
Other
Enumeration date
05/26/2015
Last updated
11/03/2015
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