Provider Demographics
NPI:1023595071
Name:WRIGHT, VANESSA (PHARM D)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5611 W WICKHAM ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67215-2049
Mailing Address - Country:US
Mailing Address - Phone:316-258-3536
Mailing Address - Fax:
Practice Address - Street 1:2020 N NELSON DR
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-2572
Practice Address - Country:US
Practice Address - Phone:316-788-3731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-106323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist