Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 8450 | MN |
NPI | 1063096667 |
---|---|
Provider Name | Isabel Mae Rizor |
First Address | Delano, MN 55328-8160 |
Second Address | Edina, MN 55435-2133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2021 |
Last Update Date | 24/08/2021 |