Jason Wrightner

Individual provider Active NPI Licensed Practical Nurse · Clay, MI

NPI 1679345672 · NPPES record last updated Oct 24, 2023

Key facts

NPI
1679345672
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703113267 (MI)
Practice address
3040 Fruit St
Clay, MI 48001-4802
Phone
(810) 543-5596
NPI assigned
Oct 24, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4703113267MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703113267 MI Yes

Addresses

Primary practice location

3040 Fruit St
Clay, MI 48001-4802

Mailing address

3040 Fruit St
Clay, MI 48001-4802

Other providers in Clay, MI

All providers in Clay, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.