Provider Demographics
NPI:1962819854
Name:RIGG, GINA M
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:RIGG
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 1:6968 STATE ROUTE 45
Mailing Address - Street 2:
Mailing Address - City:BRISTOLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44402-9775
Mailing Address - Country:US
Mailing Address - Phone:330-240-2750
Mailing Address - Fax:
Practice Address - Street 1:6968 STATE ROUTE 45
Practice Address - Street 2:
Practice Address - City:BRISTOLVILLE
Practice Address - State:OH
Practice Address - Zip Code:44402-9775
Practice Address - Country:US
Practice Address - Phone:330-240-2750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-13
Last Update Date:2014-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2074053Medicaid