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General NPI Number Information
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NPI Number | 1629470125
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Entity Type | Individual
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Provider Name | ANDRONICA WIGGINS NP
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Gender | Female
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 2200 MEDICAL CENTER BLVD STE 200
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-7765
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Country | US
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Telephone | 404-962-6000
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Fax | 404-962-6001
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Provider Business Mailing Address
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Address Line | 2200 MEDICAL CENTER BLVD STE 200
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-7765
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Country | US
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Telephone | 404-962-6000
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Fax | 404-962-6001
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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 | RN165716
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License Number State | GA
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