Individual
MRS. NICOLE RENEE RISSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
351 DELNOR DR STE 200, GENEVA, IL 60134-4226
(630) 938-8800
(630) 933-2009
Mailing address
351 DELNOR DR STE 200, GENEVA, IL 60134-4226
(630) 938-8800
(630) 933-2009
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.008894
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147096
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
10/06/2011
Last updated
07/29/2024
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