Healthcare Provider Details

I. General information

NPI: 1124935549
Provider Name (Legal Business Name): TERRI LOUISE RIESER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5880 ROSEWHIT DR
LOOMIS CA
95650-9509
US

IV. Provider business mailing address

5880 ROSEWHIT DR
LOOMIS CA
95650-9509
US

V. Phone/Fax

Practice location:
  • Phone: 513-546-8082
  • Fax:
Mailing address:
  • Phone: 513-546-8082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number230675
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: