Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 7240 | CA |
NPI | 1093153140 |
---|---|
Provider Name | Joan Elaine Rigdon |
First Address | Pasadena, CA 91116-6127 |
Second Address | Arcadia, CA 91066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2013 |
Last Update Date | 11/06/2013 |