Provider Demographics
NPI:1780012385
Name:RIGGIO, BEVERLY (MSN, OCN, APRN, NP-C)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:
Last Name:RIGGIO
Suffix:
Gender:F
Credentials:MSN, OCN, APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 18TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-5112
Mailing Address - Country:US
Mailing Address - Phone:970-347-5780
Mailing Address - Fax:970-347-5797
Practice Address - Street 1:1675 18TH AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-5112
Practice Address - Country:US
Practice Address - Phone:970-347-5780
Practice Address - Fax:970-347-5797
Is Sole Proprietor?:No
Enumeration Date:2013-10-17
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0166700163W00000X
COAPN.0990907-NP363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11103388Medicaid
WY137617900Medicaid
CO11103388Medicaid