Provider Demographics
NPI:1679872683
Name:WIGGINS, ASHLEY D (ARNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:D
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-9303
Mailing Address - Country:US
Mailing Address - Phone:270-759-9200
Mailing Address - Fax:270-759-9966
Practice Address - Street 1:1000 S 12TH ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-9303
Practice Address - Country:US
Practice Address - Phone:270-759-9200
Practice Address - Fax:270-759-9966
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006848363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily