Individual
HEATHER RIEDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 825-7084
Mailing address
3448 MONO DR, RIVERSIDE, CA 92506-2117
(951) 206-0416
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
95022444
CA
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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