Provider Demographics
NPI:1144195595
Name:WRIGHT, ALICIA SHANIECE
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:SHANIECE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 SW 52ND AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6928
Mailing Address - Country:US
Mailing Address - Phone:754-204-5969
Mailing Address - Fax:
Practice Address - Street 1:4005 SW 52ND AVE APT 208
Practice Address - Street 2:
Practice Address - City:PEMBROKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-6928
Practice Address - Country:US
Practice Address - Phone:754-204-5969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9657602163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse