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NPI Code Detail

MEDICARE: STEPHANIE L WIGGINS APRN

MEDICARE:   STEPHANIE L WIGGINS  APRN
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
1363LF0000XFamily Nurse PractitionerA004543AR

General Provider Information

NPI Number : 1457721359
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE L WIGGINS APRN
Provider Business Mailing Address
First Line : PO BOX 1960
Second Line :
City : JONESBORO
State : AR
Zip : 72403-1960
Country : US
Telephone Number : 870-936-8000
Fax Number : 870-931-4790
Provider Business Practice Location Address
First Line : 2205 W PARKER RD
Second Line :
City : JONESBORO
State : AR
Zip : 72404-7778
Country : US
Telephone Number : 870-936-8000
Fax Number : 870-931-4790
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2015
Last Update Date : 10/05/2015

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Directions to “ STEPHANIE L WIGGINS APRN” Practice Location

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