Healthcare Provider Details

I. General information

NPI: 1407162050
Provider Name (Legal Business Name): KATHRYN WRIGGELSWORTH DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2010
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 BROAD ST
DURHAM NC
27705-4142
US

IV. Provider business mailing address

910 BROAD ST
DURHAM NC
27705-4142
US

V. Phone/Fax

Practice location:
  • Phone: 919-416-4191
  • Fax:
Mailing address:
  • Phone: 919-416-4191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number195204
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: