Provider Demographics
NPI:1295721835
Name:NELSON RIETZ, KAREN ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ANN
Last Name:NELSON RIETZ
Suffix:
Gender:
Credentials:PHD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:948 DUCK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-8674
Mailing Address - Country:US
Mailing Address - Phone:319-382-6930
Mailing Address - Fax:319-337-0686
Practice Address - Street 1:221 E COLLEGE ST STE 211
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-1759
Practice Address - Country:US
Practice Address - Phone:319-382-6930
Practice Address - Fax:319-337-0686
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00811103TC0700X
IA0811103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA49514Medicare PIN
IAI09230287Medicare PIN
IA620006047Medicare PIN