Healthcare Provider Details

I. General information

NPI: 1154247062
Provider Name (Legal Business Name): ANN WIGTON PHARMD
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 6TH AVE N
SAINT CLOUD MN
56303-1901
US

IV. Provider business mailing address

1406 6TH AVE N
SAINT CLOUD MN
56303-1901
US

V. Phone/Fax

Practice location:
  • Phone: 320-255-5986
  • Fax:
Mailing address:
  • Phone: 320-255-5986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License Number120467
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: