Provider Demographics
NPI:1629673686
Name:RIGGLEMAN, NAOMI
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:RIGGLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7649 FORD HILL RD
Mailing Address - Street 2:
Mailing Address - City:RIO
Mailing Address - State:WV
Mailing Address - Zip Code:26755-6413
Mailing Address - Country:US
Mailing Address - Phone:304-703-7385
Mailing Address - Fax:
Practice Address - Street 1:7649 FORD HILL RD
Practice Address - Street 2:
Practice Address - City:RIO
Practice Address - State:WV
Practice Address - Zip Code:26755-6413
Practice Address - Country:US
Practice Address - Phone:304-703-7385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV814923747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant