| Doctor Name: | MS. KELLEY ANN MULDOON RIEGER |
| NPI Number: | 1033394648 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 06944 |
| Business Practice Address: | 3733 Park East Dr Suite 102 Beachwood, OH - 441224338 |
| Business Phone Number: | 2165911515 |
| Business Fax Number: | 2165911544 |
| Mailing Address: | 3733 Park East Dr, Suite 102 BEACHWOOD |
| State: | OH |
| Postal Code: | 441224338 |
| Phone Number: | 2165911515 |
| Fax Number: | 2165911544 |
| NPI Enumeration Date: | 01/02/2008 |
| NPI Last Update Date: | 01/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 06944 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |