Individual
JENNIFER RISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
102 MAJOR ALLEN ST, MARTIN, SD 57551-6005
(605) 685-1660
(605) 685-1166
Mailing address
102 MAJOR ALLEN, PO BOX 70D, MARTIN, SD 57551-6305
(605) 685-1660
(605) 685-1166
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
CP001390
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP001390
SD BON
SD
Enumeration date
06/21/2018
Last updated
06/21/2018
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