Individual
MRS. RENEKA SHAVON WIGGINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
716 W BROADWAY, LOUISVILLE, KY 40202-2216
(502) 595-7744
(502) 595-7007
Mailing address
716 W BROADWAY, LOUISVILLE, KY 40202-2216
(502) 595-7744
(502) 595-7007
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3013441
KY
Other
Enumeration date
07/19/2019
Last updated
08/01/2019
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