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General NPI Number Information
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NPI Number | 1386302214
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Entity Type | Individual
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Provider Name | MICHELLE N WIGGINS APRN
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Gender | Female
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 110 KINGS DR
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City | MAYFIELD
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State | KY
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Zip | 42066-3602
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Country | US
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Telephone | 270-804-7710
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Fax | 270-804-7722
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Provider Business Mailing Address
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Address Line | PO BOX 497
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City | AUGUSTA
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State | AR
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Zip | 72006-0497
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Country | US
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Telephone | 870-347-2534
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Fax | 870-301-2092
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3017425
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License Number State | KY
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