| Ms Noelle Klawon Riesen, | |
|
12196 County Road 512, Fellsmere, FL 32948-5463 | |
| (772) 257-8224 | |
| (772) 252-3245 |
| Full Name | Ms Noelle Klawon Riesen |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 6 Years |
| Location | 12196 County Road 512, Fellsmere, Florida |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386256485 | NPI | - | NPPES |
| OW686 | Other | FL | FL HF MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 11005813 (Florida) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Treasure Coast Community Health Inc | 4082625827 | 24 |
| Entity Name | Florida Department Of Health |
|---|---|
| Entity Type | Part B Supplier - Public Health/welfare Agency |
| Entity Identifiers | NPI Number: 1790746535 PECOS PAC ID: 3072424282 Enrollment ID: O20061222000176 |
| Entity Name | Treasure Coast Community Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891740916 PECOS PAC ID: 4082625827 Enrollment ID: O20130401000508 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Noelle Klawon Riesen, 1555 Indian River Blvd Ste B210, Vero Beach, FL 32960-7113 Ph: (772) 257-8224 | Ms Noelle Klawon Riesen, 12196 County Road 512, Fellsmere, FL 32948-5463 Ph: (772) 257-8224 |
Regina Therese Larkin, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 12196 County Road 512, Fellsmere, FL 32948 Phone: 772-257-8224 Fax: 772-252-3245 | |
Sonia Redio Rondon, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12196 County Road 512, Fellsmere, FL 32948 Phone: 772-257-8224 Fax: 772-213-3157 | |
Tonya Lynn Succio, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12196 County Road 512, Fellsmere, FL 32948 Phone: 772-257-8224 Fax: 772-213-3157 |