Provider Demographics
NPI:1346661410
Name:WIGGINS, ASHLEY WEAVER (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:WEAVER
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:LAUREN
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7987
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36670-0987
Mailing Address - Country:US
Mailing Address - Phone:251-633-0573
Mailing Address - Fax:251-633-7367
Practice Address - Street 1:5955 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608
Practice Address - Country:US
Practice Address - Phone:251-633-0573
Practice Address - Fax:251-633-7367
Is Sole Proprietor?:No
Enumeration Date:2013-12-17
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-121798363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL3800059OtherUHC
AL102I509402OtherMEDICARE
AL511-42793OtherBCBS OF AL
AL511-42792OtherBCBS
ALP01309534OtherRR MEDICARE
MS200008788Medicaid
AL512-05762OtherBCBS OF AL
AL216033Medicaid
AL4986031OtherAETNA
ALZ99922OtherVIVA HEALTH
AL215614Medicaid
AL512-05763OtherBCBS
ALP01309534OtherRR MEDICARE
AL102I509402OtherMEDICARE
AL3800059OtherUHC
AL511-42793OtherBCBS
AL221479Medicaid