Individual
MRS. LISA RIEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-3069
Mailing address
1460 WILLOW WOODS WAY, WINSTON SALEM, NC 27104-1226
(336) 760-9601
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
133107
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051004
—
NC
Enumeration date
06/08/2006
Last updated
12/17/2007
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