Provider Demographics
NPI:1487969721
Name:WRIGHT, MERONICA LATISHA (CNA)
Entity type:Individual
Prefix:MISS
First Name:MERONICA
Middle Name:LATISHA
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MISS
Other - First Name:MERONICA
Other - Middle Name:LATISHA
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:112 W WASHINGTON ST
Mailing Address - Street 2:SUITE 508
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-5246
Mailing Address - Country:US
Mailing Address - Phone:757-512-4191
Mailing Address - Fax:757-512-4191
Practice Address - Street 1:112 W WASHINGTON ST
Practice Address - Street 2:SUITE 508
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5246
Practice Address - Country:US
Practice Address - Phone:757-512-4191
Practice Address - Fax:757-512-4191
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide