Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 2017-01011 | NC |
NPI | 1972923753 |
---|---|
Provider Name | Kiri Wiggins Bagley |
First Address | Chapel Hill, NC 27599-7155 |
Second Address | Chapel Hill, NC 27514-4220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2014 |
Last Update Date | 09/01/2018 |