Provider Demographics
NPI:1730620279
Name:WIGINGTON, TERRI LEE (RN, MSN)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:LEE
Last Name:WIGINGTON
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 LARK MEADOW CIR
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-7520
Mailing Address - Country:US
Mailing Address - Phone:214-557-4308
Mailing Address - Fax:
Practice Address - Street 1:6363 LARK MEADOW CIR
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-7520
Practice Address - Country:US
Practice Address - Phone:214-557-4308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX744855163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical