Provider Demographics
NPI:1326848318
Name:WIGGINTON, DEANNA LEIGH (APRN)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:LEIGH
Last Name:WIGGINTON
Suffix:
Gender:
Credentials:APRN
Other - Prefix:MS
Other - First Name:DEANNA
Other - Middle Name:LEIGH
Other - Last Name:FULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:606-330-7835
Mailing Address - Fax:859-543-1989
Practice Address - Street 1:3470 BLAZER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1887
Practice Address - Country:US
Practice Address - Phone:859-629-7110
Practice Address - Fax:859-543-1989
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4036290363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care