Individual
MRS. MARSHALL ROMONA WIGFALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, FNP, PMH-NP/CNS
Contact information
Practice address
1700 HUGUENOT RD STE E, MIDLOTHIAN, VA 23113-2397
(804) 594-6837
(804) 621-2248
Mailing address
PO BOX 1556, MIDLOTHIAN, VA 23113-1556
(804) 594-6837
(804) 621-2248
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001190712
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024168559
VA
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
0015000882
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629306139
—
VA
Enumeration date
11/20/2009
Last updated
04/20/2022
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