Provider Demographics
NPI:1659748275
Name:RIES, MICHELE
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:RIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 ELLIOTT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-3436
Mailing Address - Country:US
Mailing Address - Phone:330-956-0541
Mailing Address - Fax:
Practice Address - Street 1:899 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1156
Practice Address - Country:US
Practice Address - Phone:614-396-9333
Practice Address - Fax:614-317-4689
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH398733163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse