Healthcare Provider Details

I. General information

NPI: 1891263463
Provider Name (Legal Business Name): TAMESHIA WIGGINS PMHNP-BC,AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2018
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 HEATHERDOWNS BLVD STE 207
TOLEDO OH
43614-4644
US

IV. Provider business mailing address

5330 HEATHERDOWNS BLVD STE 207
TOLEDO OH
43614-4644
US

V. Phone/Fax

Practice location:
  • Phone: 419-314-9535
  • Fax: 419-469-5495
Mailing address:
  • Phone: 419-314-9535
  • Fax: 419-469-5495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number847075
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.023855
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5017112
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.023855
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number847075
License Number StateNV
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024190119
License Number StateVA
# 7
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.023855
License Number StateOH
# 8
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704356033
License Number StateMI
# 9
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5017112
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: