Provider Demographics
NPI:1275303646
Name:RIGLESBERGER, GWEN DALETH (LPN)
Entity Type:Individual
Prefix:MRS
First Name:GWEN
Middle Name:DALETH
Last Name:RIGLESBERGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6904 SACRED CIR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-5469
Mailing Address - Country:US
Mailing Address - Phone:760-590-3886
Mailing Address - Fax:
Practice Address - Street 1:9400 GATEWAY DR STE A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-8907
Practice Address - Country:US
Practice Address - Phone:775-348-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16920164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse