Provider Demographics
NPI:1568431039
Name:RIERSON, JANETTE C (CNM)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:C
Last Name:RIERSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 N MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2477
Mailing Address - Country:US
Mailing Address - Phone:956-630-0240
Mailing Address - Fax:956-630-1470
Practice Address - Street 1:4324 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504
Practice Address - Country:US
Practice Address - Phone:956-630-0240
Practice Address - Fax:965-630-1470
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX508535367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR-91162Medicare UPIN