Basic Information
Provider Information
NPI: 1972154227
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIEGER
FirstName: MIRIAM
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 912 ASPEN ST NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200122512
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2041 GEORGIA AVENUE
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200590001
CountryCode: US
TelephoneNumber: 2028656100
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/26/2019
LastUpdateDate: 09/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000XRN1015913DCY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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