Provider Demographics
NPI:1528409174
Name:REBER, MARIA ANN (NP)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ANN
Last Name:REBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ANN
Other - Last Name:RIETSCHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5400 FRANTZ RD STE 250
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-6102
Mailing Address - Country:US
Mailing Address - Phone:614-533-6553
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:800 MCCONNELL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3463
Practice Address - Country:US
Practice Address - Phone:614-566-5019
Practice Address - Fax:614-566-1901
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA-14715-NP363L00000X
OHCOA.14715-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
1528409174OtherHUMANA
OH1528409174OtherMEDICAL MUTUAL OF OHIO
H237710Medicare UPIN