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Individual

WENNIFER D. WIGGINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P

Contact information

Practice address
5500 KNOLL NORTH DR STE 370, COLUMBIA, MD 21045-2393
(410) 837-2050
(866) 629-0091
Mailing address
1111 N CHARLES ST, BALTIMORE, MD 21201-5505
(410) 837-2050
(866) 629-0091

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R128496
MD
363LF0000X
Family Nurse Practitioner
RN1006636
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
037337200
DC
05
412982201
MD
Enumeration date
11/06/2006
Last updated
04/25/2019
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