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Wallace T. Wiggam, RN
Addiction (Substance Use Disorder) Registered Nurse in Santa Rosa, California
NPI 1932739141

Wallace T. Wiggam is an Addiction (Substance Use Disorder) Registered Nurse based in Santa Rosa, CA and is specialized in Addiction (Substance Use Disorder). Wallace T. Wiggam practices in Santa Rosa, CA and has the professional credentials of RN. The NPI Number for Wallace T. Wiggam is 1932739141 and holds a License No. 307469 (California).

The current practice location address for Wallace T. Wiggam is 2403 Professional Dr # Ca, Santa Rosa, CA and can be reached out via phone at 707-544-3295. You can also correspond with Wallace T. Wiggam through the mailing address at 2403 PROFESSIONAL DR # CA, SANTA ROSA, CA - 95403-3007 (mailing address contact number: 707-544-3295).

Location: 2403 Professional Dr # Ca, Santa Rosa, CA, 95403-3007
person
Provider Profile Details
NPI Number
1932739141
Provider Name
Wallace T. Wiggam
Credential
RN
Provider Entity Type
Individual
Gender
Male
Address
2403 Professional Dr # Ca, Santa Rosa, CA, 95403-3007
Phone Number
707-544-3295
Fax Number
Provider Enumeration Date
01/16/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2403 Professional Dr # Ca
City
State
Zip
95403-3007
Phone Number
707-544-3295
Fax Number
person
Provider Business Mailing Address Details
Address
2403 Professional Dr # Ca
City
State
Zip
95403-3007
Phone Number
707-544-3295
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
307469 (California)
Definition
Definition to come...
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