Provider Demographics
NPI:1245654490
Name:RIGGINS, SHERRY
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:
Last Name:RIGGINS
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 1:2902 S 36TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4561
Mailing Address - Country:US
Mailing Address - Phone:479-649-7927
Mailing Address - Fax:
Practice Address - Street 1:2902 S 36TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4561
Practice Address - Country:US
Practice Address - Phone:479-649-7927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR22OtherRESPIRATORY, REHABILITATIVE, & RESTORATIVE SERVICE PROVIDERS