NPI | 1861986440 |
---|---|
Former Name | AMY MICHELLE RILEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9489470) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012344) |
Enumeration Date | 2018-06-18 |
Last Update Date | 2024-04-30 |