Provider Demographics
NPI:1720754567
Name:RISHER, TREVA VANISE (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:TREVA
Middle Name:VANISE
Last Name:RISHER
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 W 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97448-1620
Mailing Address - Country:US
Mailing Address - Phone:541-227-1109
Mailing Address - Fax:
Practice Address - Street 1:3312 GATEWAY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-1054
Practice Address - Country:US
Practice Address - Phone:541-204-4745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200140842RN363L00000X
OR202111129NP-PP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner