Provider Demographics
NPI:1720969926
Name:RIZZO, JENNIFER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:RIZZO
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:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:EMBUDO
Mailing Address - State:NM
Mailing Address - Zip Code:87531-0236
Mailing Address - Country:US
Mailing Address - Phone:731-535-4969
Mailing Address - Fax:
Practice Address - Street 1:219 STATE ROAD 75
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:NM
Practice Address - Zip Code:87527-9998
Practice Address - Country:US
Practice Address - Phone:731-535-4969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula