Healthcare Provider Details

I. General information

NPI: 1871498006
Provider Name (Legal Business Name): ANGELICA WIGGINS DNAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S 23RD ST
FORT PIERCE FL
34950-4803
US

IV. Provider business mailing address

4865 ARABELLA CIR
VERO BEACH FL
32967-4403
US

V. Phone/Fax

Practice location:
  • Phone: 772-461-4000
  • Fax:
Mailing address:
  • Phone: 772-240-4874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number11051442
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: