Provider Demographics
NPI:1326395138
Name:RIEKEN, ANN MARIE (RN)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:RIEKEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2980 RICE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE CANADA
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2230
Mailing Address - Country:US
Mailing Address - Phone:651-488-4655
Mailing Address - Fax:
Practice Address - Street 1:2980 RICE ST
Practice Address - Street 2:
Practice Address - City:LITTLE CANADA
Practice Address - State:MN
Practice Address - Zip Code:55113-2230
Practice Address - Country:US
Practice Address - Phone:651-488-4655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2080702-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health