Individual
MELODY KATHLEEN RISTAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN, CHPN
Contact information
Practice address
123 INTERNATIONAL WAY, SPRINGFIELD, OR 97477-1047
(458) 205-7400
Mailing address
1055 JUNIPER ST, JUNCTION CITY, OR 97448-1935
(541) 255-5187
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
200541535RN
OR
163WH0200X
Home Health Registered Nurse
200541535RN
OR
163WH1000X
Hospice Registered Nurse
Primary
200541535RN
OR
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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