Provider Demographics
NPI:1700614146
Name:RISTER, ROSIE
Entity type:Individual
Prefix:
First Name:ROSIE
Middle Name:
Last Name:RISTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HIGHLAND HOLW APT 49
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-8738
Mailing Address - Country:US
Mailing Address - Phone:937-515-5835
Mailing Address - Fax:
Practice Address - Street 1:50 HIGHLAND HOLW APT 49
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-8738
Practice Address - Country:US
Practice Address - Phone:937-515-5835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide