| |
5330 Heatherdowns Blvd Ste 207 Toledo OH 43614-4644 | |
(419) 314-9535 | |
(419) 469-5495 |
Full Name | |
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Speciality | Nurse Practitioner |
Location | 5330 Heatherdowns Blvd Ste 207, Toledo, Ohio |
Authorized Official Name and Position | Tameshia Wiggins (NP-C) |
Authorized Official Contact | 4193149535 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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5330 Heatherdowns Blvd Ste 207 Toledo OH 43614-4644 Ph: (419) 314-9535 | 5330 Heatherdowns Blvd Ste 207 Toledo OH 43614-4644 Ph: (419) 314-9535 |
NPI Number | 1265142780 |
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Provider Enumeration Date | 11/28/2022 |
Last Update Date | 11/19/2024 |
Certification Date | 11/19/2024 |
Medicare PECOS PAC ID | 2961869805 |
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Medicare Enrollment ID | O20230607002567 |
Identifier | Type | State | Issuer |
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1265142780 | NPI | - | NPPES |
Provider Name | Tameshia Wiggins |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891263463 PECOS PAC ID: 3577804376 Enrollment ID: I20221114000182 |
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