Individual
MRS. JACKIE MARIE RIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP, FNP-C
Contact information
Practice address
413 N 17TH AVE STE 100, WAUSAU, WI 54401-4287
(715) 298-4454
(715) 802-8568
Mailing address
11825 STATE ROUTE 40 STE 100, DUNLAP, IL 61525-8842
(715) 892-0616
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9354-33
WI
363LF0000X
Family Nurse Practitioner
9354-33
WI
Other
Enumeration date
07/19/2019
Last updated
05/08/2024
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