Doctor Name: | SONIA C WIGGINS |
NPI Number: | 1063676146 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | RN104534 |
Business Practice Address: | 611 E Washington Ave Ashburn, GA - 317145315 |
Business Phone Number: | 2295673404 |
Business Fax Number: | |
Mailing Address: | 907 18th St E, Suite 150 TIFTON |
State: | GA |
Postal Code: | 317943643 |
Phone Number: | 2293533422 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2008 |
NPI Last Update Date: | 06/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN104534 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |