Provider Demographics
NPI:1871263996
Name:RIGGINS, CARL MICHAEL (RN)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:MICHAEL
Last Name:RIGGINS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 E SNOW RD
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-9123
Mailing Address - Country:US
Mailing Address - Phone:269-473-6538
Mailing Address - Fax:269-473-6154
Practice Address - Street 1:2121 E SNOW RD
Practice Address - Street 2:
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-9123
Practice Address - Country:US
Practice Address - Phone:269-473-6538
Practice Address - Fax:269-473-6154
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2139080505163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management