NPI | 1871197129 |
---|---|
Former Name | CAROLYN BARTON RILEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 33740) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000185618) |
Enumeration Date | 2020-11-27 |
Last Update Date | 2023-11-16 |