Individual
CAROLANN RISLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4600 VEGA ST, PASCAGOULA, MS 39581-5303
(228) 762-1117
Mailing address
7008 OCEAN SPRINGS RD, OCEAN SPRINGS, MS 39564-8226
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
R863092
MS
Other
Enumeration date
11/11/2010
Last updated
11/11/2010
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