Provider Demographics
NPI:1912984675
Name:WIGGINS, HELEN LIANA (CRNA)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:LIANA
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13601 PRESTON RD
Mailing Address - Street 2:SUITE 900W
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-4911
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-386-4292
Practice Address - Street 1:4255 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6412
Practice Address - Country:US
Practice Address - Phone:972-789-2816
Practice Address - Fax:866-554-1429
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX255827367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
R70001Medicare UPIN
TX82012HMedicare ID - Type Unspecified606K
TX8B1991Medicare ID - Type Unspecified339K