Healthcare Provider Details

I. General information

NPI: 1346811635
Provider Name (Legal Business Name): JESSICA MARIE RIGGLEMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 S MAIN ST
MOOREFIELD WV
26836-1238
US

IV. Provider business mailing address

747 N MAIN ST STE C
MOOREFIELD WV
26836-1336
US

V. Phone/Fax

Practice location:
  • Phone: 304-538-2331
  • Fax: 304-538-2533
Mailing address:
  • Phone: 304-538-8000
  • Fax: 304-538-8014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number110238
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberPENDING
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: