Provider Demographics
NPI:1104107333
Name:WIGGINS, ADA MAE
Entity type:Individual
Prefix:MS
First Name:ADA
Middle Name:MAE
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ADA
Other - Middle Name:MAE
Other - Last Name:HELMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 7TH AVE E
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-3706
Mailing Address - Country:US
Mailing Address - Phone:828-692-5329
Mailing Address - Fax:828-692-1258
Practice Address - Street 1:310 7TH AVE E
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-3706
Practice Address - Country:US
Practice Address - Phone:828-692-5329
Practice Address - Fax:828-692-1258
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist