Provider Demographics
NPI:1255686101
Name:WIGGINS, ELENA A (ARNP)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:A
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8606 VILLAGE DR
Mailing Address - Street 2:STE A
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5506
Mailing Address - Country:US
Mailing Address - Phone:210-657-0220
Mailing Address - Fax:210-590-7288
Practice Address - Street 1:5623 HAMILTON WOLFE
Practice Address - Street 2:APT 734
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3991
Practice Address - Country:US
Practice Address - Phone:503-998-4494
Practice Address - Fax:210-614-1722
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2019-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60295601363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics