Provider Demographics
NPI:1962111245
Name:WIGLER, SHELLEY BROOKE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:BROOKE
Last Name:WIGLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-1093
Mailing Address - Country:US
Mailing Address - Phone:215-870-5480
Mailing Address - Fax:
Practice Address - Street 1:638 NEWTOWN YARDLEY RD STE 2E
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1738
Practice Address - Country:US
Practice Address - Phone:215-968-1616
Practice Address - Fax:215-860-1976
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026617363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology