Provider Demographics
NPI:1184024333
Name:RISEN, MARLEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARLEE
Middle Name:
Last Name:RISEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 MOUNT WELCOME STE 11
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-3610
Mailing Address - Country:US
Mailing Address - Phone:340-719-7283
Mailing Address - Fax:340-719-7284
Practice Address - Street 1:2024 MOUNT WELCOME STE 11
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-3610
Practice Address - Country:US
Practice Address - Phone:340-719-7283
Practice Address - Fax:340-719-7284
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist