Provider Demographics
NPI:1235484981
Name:RIGBY, MATTHEW LEE (CRNA)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:LEE
Last Name:RIGBY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:684 COUNTRY CLB
Mailing Address - Street 2:
Mailing Address - City:STANSBURY PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84074-9604
Mailing Address - Country:US
Mailing Address - Phone:435-590-6214
Mailing Address - Fax:
Practice Address - Street 1:129 W LAKE MEAD PKWY
Practice Address - Street 2:SUITE B18
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-6954
Practice Address - Country:US
Practice Address - Phone:702-564-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV000454367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered