Individual
MS. SUSAN MERCEDES RIEBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1721 E 19TH AVE STE 300, DENVER, CO 80218
(720) 754-4800
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 342-1387
(480) 342-1388
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4868
CO
363AS0400X
Surgical Physician Assistant
4722
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4868
COLORADO PA LICENSE
CO
Enumeration date
09/28/2010
Last updated
08/28/2018
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