Provider Demographics
NPI:1619456738
Name:RIZER, RAYMONDA
Entity Type:Individual
Prefix:
First Name:RAYMONDA
Middle Name:
Last Name:RIZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5932 DAKOTA BAY ST
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-6831
Mailing Address - Country:US
Mailing Address - Phone:312-656-6768
Mailing Address - Fax:
Practice Address - Street 1:5932 DAKOTA BAY ST
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-6831
Practice Address - Country:US
Practice Address - Phone:312-656-6768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide