Provider Demographics
NPI:1518414226
Name:RIFFLE, JIMMIE GERALD II (FNP)
Entity type:Individual
Prefix:MR
First Name:JIMMIE
Middle Name:GERALD
Last Name:RIFFLE
Suffix:II
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 E LITTLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-3952
Mailing Address - Country:US
Mailing Address - Phone:757-772-6122
Mailing Address - Fax:
Practice Address - Street 1:1326 E LITTLE CREEK RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-3952
Practice Address - Country:US
Practice Address - Phone:757-772-6122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-10
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV75563163W00000X
WV103914363LF0000X
VA0024179960363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse