Individual
MS. EDITH LOSEY WIGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
2415 W VERNON AVENUE, CASWELL CENTER, KINSTON, NC 28504
(252) 208-4066
(252) 208-4035
Mailing address
1987 BANKS SCHOOL ROAD, KINSTON, NC 28504
(252) 520-2069
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
101945
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3406105
—
NC
Enumeration date
02/05/2007
Last updated
07/09/2007
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