Individual
MRS. MICCA R RIEDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP-C, GNP-BC
Contact information
Practice address
610 STRICKLAND DR STE 130, ORANGE, TX 77630-4788
(409) 291-8710
(409) 247-2105
Mailing address
610 STRICKLAND DR STE 130, ORANGE, TX 77630-4788
(409) 291-8710
(409) 247-2105
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP121473
TX
363LG0600X
Gerontology Nurse Practitioner
AP121473
TX
Other
Enumeration date
01/11/2012
Last updated
08/13/2024
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