Basic Information
Provider Information
NPI: 1407862345
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WRIGHT
FirstName: CHRISTINA
MiddleName: L
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: VERNEUIL
OtherFirstName: CHRISTINA
OtherMiddleName: L
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 1717 COWLES ST
Address2:  
City: FAIRBANKS
State: AK
PostalCode: 99701
CountryCode: US
TelephoneNumber: 9074516682
FaxNumber:  
Practice Location
Address1: 1717 COWLES ST
Address2:  
City: FAIRBANKS
State: AK
PostalCode: 99701
CountryCode: US
TelephoneNumber: 9074516682
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/31/2006
LastUpdateDate: 12/06/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X5217AKY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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