MEDICARE: DANIELLE YVETTE WIGGINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	601398600720	OH
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1083362412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE YVETTE WIGGINS

Provider Business Mailing Address
First Line	:	3211 ANDY TER
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43223-3483
Country	:	US
Telephone Number	:	216-773-0184
Fax Number	:

Provider Business Practice Location Address
First Line	:	3211 ANDY TER
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43223-3483
Country	:	US
Telephone Number	:	216-773-0184
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2022
Last Update Date	:	08/20/2025

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