Provider Demographics
NPI:1972318970
Name:WIGGINS, TIFFANY D (LPN)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:D
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13317 ALPINE DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-5539
Mailing Address - Country:US
Mailing Address - Phone:228-326-5508
Mailing Address - Fax:
Practice Address - Street 1:13317 ALPINE DR
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-5539
Practice Address - Country:US
Practice Address - Phone:228-326-5508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-08
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 376J00000X, 372500000X, 372600000X, 251J00000X, 374U00000X
MS336553164W00000X
MS253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No376J00000XNursing Service Related ProvidersHomemaker
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No374U00000XNursing Service Related ProvidersHome Health Aide