Provider Demographics
NPI:1346276839
Name:RISSER, LINDA D (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:D
Last Name:RISSER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:RISSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:1 BROOKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-3914
Mailing Address - Country:US
Mailing Address - Phone:603-437-7824
Mailing Address - Fax:
Practice Address - Street 1:100 HITCHCOCK WAY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-4125
Practice Address - Country:US
Practice Address - Phone:603-695-2900
Practice Address - Fax:603-695-2919
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH032075-23-04363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30340304Medicaid
NH30340304Medicaid
P06884Medicare UPIN