Basic Information
Provider Information
NPI: 1427710318
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIGGANS
FirstName: SHAUNA
MiddleName: HANDY
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 200 NORTHVIEW PLZ
Address2:  
City: NORTH WILKESBORO
State: NC
PostalCode: 286593173
CountryCode: US
TelephoneNumber: 3368180607
FaxNumber:  
Practice Location
Address1: 200 NORTHVIEW PLZ
Address2:  
City: NORTH WILKESBORO
State: NC
PostalCode: 286593173
CountryCode: US
TelephoneNumber: 3368180607
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/08/2021
LastUpdateDate: 10/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialMiddleName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X  Y Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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