Individual provider · Type 1 NPI

Courtney Riecken

Nurse Practitioner · Fort Wayne, IN

NPI number 1649809732 Active

Practice location

7910 W Jefferson Blvd Ste 108
Fort Wayne, IN 46804-4159

Call (260) 436-0800 Map

Fax (260) 483-1911

Mailing address

PO Box 749495
Atlanta, GA 30374-9495

Other practice locations

11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 · (260) 266-2020

Specialties and licenses

Taxonomy	Code	License
Registered Nurse	163W00000X	28183130A (IN)
Nurse Practitioner Primary	363L00000X	71010042A (IN)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1649809732

Courtney Riecken's National Provider Identifier is 1649809732, issued on Apr 2, 2020. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Fort Wayne, IN. The record was last updated on Nov 19, 2025.