Healthcare Provider Details

I. General information

NPI: 1013314350
Provider Name (Legal Business Name): VALERIE ANN RIESBERG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 12/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 PACIFIC AVE
AUDUBON IA
50025-1056
US

IV. Provider business mailing address

515 PACIFIC AVE
AUDUBON IA
50025-1056
US

V. Phone/Fax

Practice location:
  • Phone: 712-563-2611
  • Fax:
Mailing address:
  • Phone: 712-563-2611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA122222
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: