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Individual

DIANA L WRIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
456 KOKOPELLI BLVD, SUITE B, FRUITA, CO 81521
(970) 639-9505
(970) 639-2993
Mailing address
300 S NEVADA AVENUE, MONTROSE, CO 81401
(970) 249-7751
(970) 249-5029

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0002968
CO
363A00000X
Physician Assistant
PA60371999
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
542099YYS0
MEDICARE FOR CEDAR POINT HEALTH
CO
05
78357250
CO
Enumeration date
02/23/2010
Last updated
08/16/2017
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