Healthcare Provider Details

I. General information

NPI: 1346276839
Provider Name (Legal Business Name): LINDA D RISSER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNN RISSER APRN

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 09/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HITCHCOCK WAY
MANCHESTER NH
03104-4125
US

IV. Provider business mailing address

1 BROOKVIEW DR
DERRY NH
03038-3914
US

V. Phone/Fax

Practice location:
  • Phone: 603-695-2900
  • Fax: 603-695-2919
Mailing address:
  • Phone: 603-437-7824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number032075-23-04
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: