Individual
MS. AMY B RISLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4300 W MEMORIAL RD, OKLAHOMA CITY, OK 73120-8304
(405) 632-2323
(405) 631-9315
Mailing address
8100 S WALKER AVE, BLDG A, OKLAHOMA CITY, OK 73139-9404
(405) 752-3162
(405) 936-5211
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1111
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200067440A
—
OK
01
—
970025354
RAILROAD MEDICARE
OK
Enumeration date
02/01/2006
Last updated
02/16/2016
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