Healthcare Provider Details

I. General information

NPI: 1831779297
Provider Name (Legal Business Name): LAURA ELIZABETH RIZER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2021
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 6TH AVE
DES MOINES IA
50314-2613
US

IV. Provider business mailing address

108 MICHAEL DR
NORWALK IA
50211-2202
US

V. Phone/Fax

Practice location:
  • Phone: 515-358-4000
  • Fax:
Mailing address:
  • Phone: 515-975-5348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number113838
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberK164452
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: