Healthcare Provider Details

I. General information

NPI: 1295144749
Provider Name (Legal Business Name): CHARRISA RIGGS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2014
Last Update Date: 05/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2875 W RAY RD STE 6-239 SUITE 8
CHANDLER AZ
85224-3524
US

IV. Provider business mailing address

1732 N CHOLLA ST
CHANDLER AZ
85224-2606
US

V. Phone/Fax

Practice location:
  • Phone: 480-793-1978
  • Fax:
Mailing address:
  • Phone: 602-570-4470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP8071
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN156324
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: