| NPI | 1982106712 |
|---|---|
| Former Name | RAELEE LYNN WIGGINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA H137415) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 137415) |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2021-06-09 |