Provider Demographics
NPI:1457944100
Name:RIGGS, MICHELLE C (RDN, LD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:C
Last Name:RIGGS
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MULVANE
Mailing Address - State:KS
Mailing Address - Zip Code:67110-1736
Mailing Address - Country:US
Mailing Address - Phone:316-461-1109
Mailing Address - Fax:
Practice Address - Street 1:1660 N TYLER RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-4917
Practice Address - Country:US
Practice Address - Phone:316-252-1154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2531133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered