Individual
COLLEEN KELLY WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
44084 RIVERSIDE PKWY, SUITE 300, LEESBURG, VA 20176-5102
(703) 724-7530
(703) 858-2870
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643
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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