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General NPI Number Information
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NPI Number | 1043390859
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Entity Type | Individual
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Provider Name | MICHELLE R RIEDEL NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 12354 W ALAMEDA PKWY STE 140
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City | LAKEWOOD
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State | CO
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Zip | 80228-2844
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Country | US
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Telephone | 720-639-4595
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Fax | 720-200-6921
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Provider Business Mailing Address
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Address Line | 12354 W ALAMEDA PKWY STE 140
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City | LAKEWOOD
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State | CO
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Zip | 80228-2844
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Country | US
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Telephone | 209-655-7097
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Fax | 720-476-5190
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71000877A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0991578-NP
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License Number State | CO
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