| Doctor Name: | MS. CHARLOTTE ANN WIGLE |
| NPI Number: | 1265534747 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP- |
| License Number: | 2834222 |
| Business Practice Address: | 801 N Bay St Eustis, FL - 327262941 |
| Business Phone Number: | 3525899661 |
| Business Fax Number: | 3525892458 |
| Mailing Address: | 720 N Bay St Ste 11, EUSTIS |
| State: | FL |
| Postal Code: | 327262964 |
| Phone Number: | 3525899661 |
| Fax Number: | 3525895983 |
| NPI Enumeration Date: | 09/04/2006 |
| NPI Last Update Date: | 10/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 2834222 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |