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General NPI Number Information
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NPI Number | 1518757384
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Entity Type | Individual
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Provider Name | TARA INEZ RIGGALL BSN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 128 PHOENIX MILLS RD
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City | COOPERSTOWN
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State | NY
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Zip | 13326-5716
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Country | US
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Telephone | 607-547-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 7888 LARKIN RD
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City | HUBBARDSVILLE
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State | NY
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Zip | 13355-1148
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Country | US
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Telephone | 607-244-1664
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0600X
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Taxonomy Name | Gerontology Registered Nurse
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License Number | 775417
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 356912
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License Number State | NY
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