Basic Information
| Provider Information | |||||||||
| NPI: | 1760867956 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | BENJAMIN | ||||||||
| MiddleName: | WARREN | ||||||||
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| Credential: | PMHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 216 | ||||||||
| Address2: | |||||||||
| City: | TOWNSHEND | ||||||||
| State: | VT | ||||||||
| PostalCode: | 053530216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8023654331 | ||||||||
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| Practice Location | |||||||||
| Address1: | 185 GRAFTON RD | ||||||||
| Address2: | |||||||||
| City: | TOWNSHEND | ||||||||
| State: | VT | ||||||||
| PostalCode: | 053530216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109148664 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2015 | ||||||||
| LastUpdateDate: | 10/24/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 101.0114082 | VT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.