MEDICARE: KATY RIEKER CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	OO37410	OH
2	163WG0100X	Gastroenterology Registered Nurse	0037410	OH

General Provider Information

NPI Number	:	1306719570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATY RIEKER CNP

Provider Business Mailing Address
First Line	:	4952 FAIRLAWN RD
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-1123
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6559 WILSON MILLS RD STE 106A
Second Line	:
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-3433
Country	:	US
Telephone Number	:	855-449-1540
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	05/07/2026

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Directions to “ KATY RIEKER CNP” Practice Location

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