Provider Demographics
NPI:1699345744
Name:RUETHER, RIKI NICHOLE (MA, AIDE)
Entity type:Individual
Prefix:
First Name:RIKI
Middle Name:NICHOLE
Last Name:RUETHER
Suffix:
Gender:F
Credentials:MA, AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 GORDON SMITH BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-6049
Mailing Address - Country:US
Mailing Address - Phone:513-320-3873
Mailing Address - Fax:
Practice Address - Street 1:2094 GARDNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-1122
Practice Address - Country:US
Practice Address - Phone:513-484-0488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRV289861OtherINDIVIDUAL PRACTITIONER