Healthcare Provider Details

I. General information

NPI: 1821350224
Provider Name (Legal Business Name): MELISSA JANE RIGGLEMAN-LAFFFERTY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 3 BOX 120
RIDGELEY WV
26753-9712
US

IV. Provider business mailing address

RR 3 BOX 120
RIDGELEY WV
26753-9712
US

V. Phone/Fax

Practice location:
  • Phone: 240-727-6680
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: