Provider Demographics
NPI:1518209253
Name:RIZZO, MARY ELIZABETH (RN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:RIZZO
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Gender:F
Credentials:RN, FNP-BC
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Other - First Name:
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Mailing Address - Street 1:1639 SE ENSIGN LN
Mailing Address - Street 2:SUITE B103
Mailing Address - City:WARRENTON
Mailing Address - State:OR
Mailing Address - Zip Code:97146-7308
Mailing Address - Country:US
Mailing Address - Phone:503-338-4500
Mailing Address - Fax:503-338-4501
Practice Address - Street 1:1639 SE ENSIGN LN
Practice Address - Street 2:SUITE B103
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146-7308
Practice Address - Country:US
Practice Address - Phone:503-338-4500
Practice Address - Fax:503-338-4501
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR201407419NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily