Healthcare Provider Details

I. General information

NPI: 1063885903
Provider Name (Legal Business Name): CARA J RIEK DNP, FNP-BC, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2015
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7730 E GREENWAY RD STE 101
SCOTTSDALE AZ
85260-1787
US

IV. Provider business mailing address

7730 E GREENWAY RD STE 101
SCOTTSDALE AZ
85260-1787
US

V. Phone/Fax

Practice location:
  • Phone: 480-208-1490
  • Fax: 480-447-8890
Mailing address:
  • Phone: 480-208-1490
  • Fax: 480-447-8890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP8745
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN168695
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: