Provider Demographics
NPI:1679016190
Name:RIESELMAN, HEATHER (CNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:RIESELMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:MLC 11024
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-803-0375
Mailing Address - Fax:513-803-1124
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:MLC 11024
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-803-0375
Practice Address - Fax:513-803-1124
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020145363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics