Individual
GERALD BRADEN WIGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
3023 FERNLEAF DR, GREENVILLE, NC 27858-8192
(252) 367-1540
Mailing address
3023 FERNLEAF DR, GREENVILLE, NC 27858-8192
(252) 367-1540
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
WIGG-4VFGTP
NC
363LF0000X
Family Nurse Practitioner
Primary
5011221
NC
Other
Enumeration date
10/09/2018
Last updated
11/30/2018
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