Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 0024172760 | VA |
NPI | 1003291956 |
---|---|
Provider Name | Mrs. Meghan Diamante Rise |
First Address | North Chesterfield, VA 23235-3612 |
Second Address | Richmond, VA 23230-1644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2015 |
Last Update Date | 21/07/2015 |