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Individual

COURTNEY RIECKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7910 W JEFFERSON BLVD STE 108, FORT WAYNE, IN 46804-4159
(260) 436-0800
(260) 483-1911
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(813) 321-1296

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28183130A
IN
363L00000X
Nurse Practitioner
Primary
71010042A
IN

Other

Enumeration date
04/02/2020
Last updated
11/19/2025
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