Basic Information
| Provider Information | |||||||||
| NPI: | 1285274175 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RHIEL | ||||||||
| FirstName: | CASSIDY | ||||||||
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| Credential: | NPS | ||||||||
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| Mailing Information | |||||||||
| Address1: | N5063 1158TH ST | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 540217508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7154955444 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2525 CHICAGO AVE | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554044518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6128136000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2020 | ||||||||
| LastUpdateDate: | 01/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0200X | 2180012 | MN | Y | Nursing Service Providers | Registered Nurse | Pediatrics |
No ID Information.