Provider Demographics
NPI:1871673020
Name:RISCH, JAMIE M (RD, LDN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:M
Last Name:RISCH
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:M
Other - Last Name:VASCIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-0579
Mailing Address - Country:US
Mailing Address - Phone:724-543-8164
Mailing Address - Fax:724-543-8616
Practice Address - Street 1:1 NOLTE DR
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7111
Practice Address - Country:US
Practice Address - Phone:724-543-8164
Practice Address - Fax:724-543-8616
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001365133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered