Provider Demographics
NPI:1326263294
Name:RISH, NADINE (RN)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:RISH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DEAN
Other - Middle Name:
Other - Last Name:RISH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:15 PUBLIC SQ
Mailing Address - Street 2:SUITE 600
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18701-1702
Mailing Address - Country:US
Mailing Address - Phone:570-823-7000
Mailing Address - Fax:570-823-3040
Practice Address - Street 1:15 PUBLIC SQ
Practice Address - Street 2:SUITE 312
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-1702
Practice Address - Country:US
Practice Address - Phone:570-826-1777
Practice Address - Fax:570-823-3040
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN179770L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015952500003Medicaid
PA1007678420038Medicaid