Basic Information
| Provider Information | |||||||||
| NPI: | 1003291956 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RISE | ||||||||
| FirstName: | MEGHAN | ||||||||
| MiddleName: | DIAMANTE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2024 NEPTUNE DR | ||||||||
| Address2: | |||||||||
| City: | NORTH CHESTERFIELD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232353612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8043501054 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6802 PARAGON PL | ||||||||
| Address2: | SUITE 410 | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232301644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8042774342 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2015 | ||||||||
| LastUpdateDate: | 07/21/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 0024172760 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.