Provider Demographics
NPI:1043540719
Name:RIEL, RENEE LEEANN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:RENEE
Middle Name:LEEANN
Last Name:RIEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 APPLE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:HOWARD
Mailing Address - State:OH
Mailing Address - Zip Code:43028-9319
Mailing Address - Country:US
Mailing Address - Phone:740-501-1399
Mailing Address - Fax:
Practice Address - Street 1:2755 APPLE VALLEY DR
Practice Address - Street 2:
Practice Address - City:HOWARD
Practice Address - State:OH
Practice Address - Zip Code:43028-9319
Practice Address - Country:US
Practice Address - Phone:740-501-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-01
Last Update Date:2010-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 128174-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse