Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 0001974 | CO |
NPI | 1003355488 |
---|---|
Provider Name | Ashley Wigington |
First Address | Oklahoma City, OK 73142-4468 |
Second Address | Aurora, CO 80011-8735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2017 |
Last Update Date | 18/01/2021 |