Healthcare Provider Details

I. General information

NPI: 1902711195
Provider Name (Legal Business Name): KIMBERLY RIEKE BSN, RN, OCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 WASHINGTON AVE
EVANSVILLE IN
47714-0541
US

IV. Provider business mailing address

1575 PLEASANT HILL RD
MARION KY
42064-8004
US

V. Phone/Fax

Practice location:
  • Phone: 812-485-4944
  • Fax:
Mailing address:
  • Phone: 812-485-4944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number28157945A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: