Provider Demographics
NPI:1376952978
Name:WIGGINS, RACHEL (CRNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 EDWINA ST
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:AL
Mailing Address - Zip Code:36401-3319
Mailing Address - Country:US
Mailing Address - Phone:251-578-0220
Mailing Address - Fax:251-578-0223
Practice Address - Street 1:225 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:GEORGIANA
Practice Address - State:AL
Practice Address - Zip Code:36033-6628
Practice Address - Country:US
Practice Address - Phone:334-376-2005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-123127363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily