Provider Demographics
NPI:1851941918
Name:WIGGINS, ANGEL (NP)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:ANGEL
Other - Middle Name:
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1010 N THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-4924
Mailing Address - Country:US
Mailing Address - Phone:804-358-6343
Mailing Address - Fax:
Practice Address - Street 1:1010 N THOMPSON ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4924
Practice Address - Country:US
Practice Address - Phone:804-358-6343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily