Provider Demographics
NPI:1912130394
Name:RISHEL, LORI ANN (FNP)
Entity type:Individual
Prefix:MISS
First Name:LORI
Middle Name:ANN
Last Name:RISHEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 S 11TH ST
Mailing Address - Street 2:SUITE 135
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-6969
Mailing Address - Country:US
Mailing Address - Phone:208-367-0700
Mailing Address - Fax:
Practice Address - Street 1:403 S 11TH ST
Practice Address - Street 2:SUITE 135
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-6969
Practice Address - Country:US
Practice Address - Phone:208-367-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-761A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily