Individual
KELLY WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1137 S DUPREE AVE STE 400, BROWNSVILLE, TN 38012-3255
(731) 779-0902
Mailing address
1137 S DUPREE AVE STE 400, BROWNSVILLE, TN 38012-3255
(731) 779-0902
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
182981
TN
363LF0000X
Family Nurse Practitioner
Primary
35582
TN
Other
Enumeration date
03/08/2017
Last updated
04/24/2024
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