Provider Demographics
NPI:1831504786
Name:WIGGINS, PATRICIA E (RPH)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:E
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 TRADEWIND CIR
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-4641
Mailing Address - Country:US
Mailing Address - Phone:410-469-0172
Mailing Address - Fax:
Practice Address - Street 1:74 TRADEWIND CIR
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-4641
Practice Address - Country:US
Practice Address - Phone:410-469-0172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-29
Last Update Date:2014-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist