Healthcare Provider Details
I. General information
NPI: 1053370486
Provider Name (Legal Business Name): JOHN RIGBY RN
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 03/23/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
302 N 2ND ST
MUSCODA WI
53573-9258
US
IV. Provider business mailing address
PO BOX 405 302 N. 2ND ST
MUSCODA WI
53573-0405
US
V. Phone/Fax
- Phone: 608-575-0708
- Fax:
- Phone: 608-575-0708
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WH0200X |
| Taxonomy | Home Health Registered Nurse |
| License Number | |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: