Individual
MRS. AMANDA S. RISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2999 N MAYFAIR RD STE 100, MILWAUKEE, WI 53222-4306
(414) 479-7000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1982-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1071546
NCCPA BOARD CERTIFICATION
WI
05
—
41947600
—
WI
Enumeration date
07/21/2006
Last updated
11/03/2025
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