Individual
RODNEY RIESLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1414 W FAIR AVE, STE 344, MARQUETTE, MI 49855-2675
(906) 225-3910
(906) 225-4529
Mailing address
PO BOX 220, MARQUETTE, MI 49855-0220
(906) 225-3910
(906) 225-4529
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
205362
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
381358036011
TRICARE
MI
05
—
4517925
—
MI
01
—
P00045838
RAILROAD MEDICARE
MI
Enumeration date
11/10/2005
Last updated
03/03/2008
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