| Doctor Name: | SUSAN B RIEK |
| NPI Number: | 1104120864 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APNP |
| License Number: | 70606 |
| Business Practice Address: | 835 Parkside St Ripon, WI - 549718505 |
| Business Phone Number: | 9207453590 |
| Business Fax Number: | |
| Mailing Address: | 420 E Division St, FOND DU LAC |
| State: | WI |
| Postal Code: | 549354560 |
| Phone Number: | 9209268340 |
| Fax Number: | 9209268370 |
| NPI Enumeration Date: | 01/10/2011 |
| NPI Last Update Date: | 04/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 70606 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |