Provider Demographics
NPI:1205728433
Name:RISON, DONALD RAY JR (JD)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:RAY
Last Name:RISON
Suffix:JR
Gender:M
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2361 BROADWATER DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4575
Mailing Address - Country:US
Mailing Address - Phone:308-999-0748
Mailing Address - Fax:
Practice Address - Street 1:2361 BROADWATER DR
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4575
Practice Address - Country:US
Practice Address - Phone:308-999-0748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant