Susan B Riek, APNP

Individual provider Active NPI Family Nurse Practitioner · Ripon, WI

NPI 1104120864 · NPPES record last updated Apr 7, 2015

Key facts

NPI
1104120864
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
4344-33 (WI)
Practice address
835 Parkside St
Ripon, WI 54971-8505
Phone
(920) 745-3590
NPI assigned
Jan 10, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
70606WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ripon Medical Center Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 70606 WI
Family Nurse Practitioner 363LF0000X 4344-33 WI Yes

Addresses

Primary practice location

835 Parkside St
Ripon, WI 54971-8505

Mailing address

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-8340

Other providers in Ripon, WI

All providers in Ripon, WI · Family Nurse Practitioner in Wisconsin

Sources for this page

Verify at the official NPI Registry.