GERALD BRADEN WIGGS


Address: 3023 Fernleaf Dr, Greenville, NC 27858-8192
Phone: 2523671540

GERALD BRADEN WIGGS (NPI# 1881169662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881169662
Entity Type Individual
Full Name GERALD BRADEN WIGGS
Credential FNP-C
Practice Address 3023 Fernleaf Dr
Greenville
NC 27858-8192
Practice Telephone 2523671540
Mailing Telephone 2523671540
Enumeration Date 2018-10-09
Last Update Date 2018-11-30
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363L00000X Nurse Practitioner WIGG-4VFGTP NC Physician Assistants & Advanced Practice Nursing Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
5011221 NC Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 3023 FERNLEAF DR
City GREENVILLE
State NC
Zip Code 27858-8192

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City GREENVILLE
Zip Code 27858

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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