Provider Demographics
NPI:1487135638
Name:WIGGINS, JEAN E
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:E
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JEAN
Other - Middle Name:E
Other - Last Name:WIGGINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:116 RALEIGH ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27855-9753
Mailing Address - Country:US
Mailing Address - Phone:252-398-2470
Mailing Address - Fax:
Practice Address - Street 1:116 RALEIGH ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:NC
Practice Address - Zip Code:27855-9753
Practice Address - Country:US
Practice Address - Phone:252-398-2470
Practice Address - Fax:252-396-8464
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-26
Last Update Date:2018-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care