Provider Demographics
NPI:1235865874
Name:RIELAND, KARLEE ROSE (CNP)
Entity Type:Individual
Prefix:
First Name:KARLEE
Middle Name:ROSE
Last Name:RIELAND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KARLEE
Other - Middle Name:ROSE
Other - Last Name:ILGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 17TH AVE E STE 101
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-5274
Mailing Address - Country:US
Mailing Address - Phone:320-335-6062
Mailing Address - Fax:320-762-1935
Practice Address - Street 1:111 17TH AVE E STE 101
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-5274
Practice Address - Country:US
Practice Address - Phone:320-335-6062
Practice Address - Fax:320-762-1935
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2431305163W00000X
MN9468363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse