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NPI Code Detail

MEDICARE: ALEXA GATHMAN RIES

MEDICARE: ALEXA GATHMAN RIES
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
1390200000XStudent in an Organized Health Care Education/Training Program
2390200000XStudent in an Organized Health Care Education/Training ProgramWI

General Provider Information

NPI Number : 1336848696
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXA GATHMAN RIES
Provider Business Mailing Address
First Line : 2900 W OKLAHOMA AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4330
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2900 W OKLAHOMA AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4330
Country : US
Telephone Number : 414-649-3323
Fax Number : 414-649-5158
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2023
Last Update Date : 04/29/2026

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