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General NPI Number Information
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NPI Number | 1902140981
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Entity Type | Individual
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Provider Name | ALICIA-ANN DANIELLE WIGGINS LPN
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Gender | Female
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 942 MONTFORD RD
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City | CLEVELAND HTS
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State | OH
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Zip | 44121-2078
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Country | US
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Telephone | 216-414-8602
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Fax |
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Provider Business Mailing Address
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Address Line | 942 MONTFORD RD
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City | CLEVELAND HEIGHTS
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State | OH
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Zip | 44121-2078
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Country | US
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Telephone | 216-414-8602
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 144320
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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