Individual
HEATHER M. RIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5301 VIRGINIA WAY, STE 300, BRENTWOOD, TN 37027-7541
(615) 221-4474
(615) 234-3774
Mailing address
5301 VIRGINIA WAY, STE 300, BRENTWOOD, TN 37027-7541
(615) 221-4474
(615) 234-3774
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
34155
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
36151
KY
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
34155
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000016015
TLC TENNCARE
TN
05
—
009964100
—
AL
01
—
100033069
PHP TENNCARE
TN
01
—
10057952
AMERIGROUP MEDICAID GACMO
GA
01
—
119451
UNISONTENNCARE
TN
01
—
3150369
BLUE CROSS
TN
01
—
335777
WELLCARE GA MEDICAID CMO
GA
05
—
3852383
—
TN
05
—
5902767
—
NC
05
—
629419657A
—
GA
05
—
64028533
—
KY
Enumeration date
09/27/2006
Last updated
05/16/2017
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