Provider Demographics
NPI:1578177861
Name:RIGGERT, KIMBERLY J (RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:J
Last Name:RIGGERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:J
Other - Last Name:KRIGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9820 N 151ST ST
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:NE
Mailing Address - Zip Code:68462-1627
Mailing Address - Country:US
Mailing Address - Phone:402-405-3881
Mailing Address - Fax:
Practice Address - Street 1:6601 GLASS RIDGE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9752
Practice Address - Country:US
Practice Address - Phone:402-436-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE65816163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool