Darralyn Dellice Wright, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN101904 Issued in OH

Practice address

87 Paxton Ave
Apt.3N
Calumet City, IL 60409-1557

Phone

(708) 566-0324

NPI assigned

Jul 2, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Darralyn Dellice Bohanan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1184887929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 PAXTON AVE",
            "address_2": "APT.3N",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604091557",
            "telephone_number": "708-566-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 PAXTON AVE",
            "address_2": "APT.3N",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604091557",
            "telephone_number": "708-566-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "DARRALYN",
        "middle_name": "DELLICE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN101904",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IN",
            "license": "27070140A",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043080115",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2686473",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARRALYN",
            "last_name": "BOHANAN",
            "middle_name": "DELLICE",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Yjr Holdings LLC
• Jasmin Christina Young

• Licensed Practical Nurse in Calumet City, IL
• Providers in Calumet City, IL by specialty
• Licensed Practical Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.