Provider Demographics
NPI:1003605940
Name:RIGGLE, CAMRYN
Entity type:Individual
Prefix:
First Name:CAMRYN
Middle Name:
Last Name:RIGGLE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CAMRYN
Other - Middle Name:
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6450 DOUBLE EAGLE DR APT 514
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1598
Mailing Address - Country:US
Mailing Address - Phone:765-491-9540
Mailing Address - Fax:
Practice Address - Street 1:121 BUNTIN ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1320
Practice Address - Country:US
Practice Address - Phone:812-885-8622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program