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Individual

LAUREN RIISOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(785) 656-3430
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(785) 656-3430

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
130130
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
130130
KSBN
KS
Enumeration date
01/13/2023
Last updated
01/13/2023
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