Provider Demographics
NPI:1033489851
Name:RIFFLE, ANN MARIE (CRNA)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:RIFFLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38636 LEADING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:45760-9740
Mailing Address - Country:US
Mailing Address - Phone:740-591-1043
Mailing Address - Fax:
Practice Address - Street 1:38636 LEADING CREEK RD
Practice Address - Street 2:
Practice Address - City:MIDDLEPORT
Practice Address - State:OH
Practice Address - Zip Code:45760-9740
Practice Address - Country:US
Practice Address - Phone:740-591-1043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12998367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered