Individual
MRS. LISA MARIA RIGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
8769 FALCON TRACE DR N, JACKSONVILLE, FL 32222-2159
(904) 200-9847
Mailing address
8769 FALCON TRACE DR N, JACKSONVILLE, FL 32222-2159
(904) 200-9847
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5200340
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R200533666900
DRIVERS LICENSE
FL
Enumeration date
01/06/2021
Last updated
01/06/2021
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