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NPI Code Detail

MEDICARE: KATHRYN RILEY

MEDICARE: KATHRYN RILEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner30671SC
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1134934870
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN RILEY
Provider Business Mailing Address
First Line : 300 E MCBEE AVE STE 300
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2899
Country : US
Telephone Number : 864-522-3700
Fax Number :
Provider Business Practice Location Address
First Line : 725 GROVE RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29605-9998
Country : US
Telephone Number : 864-455-6968
Fax Number : 864-455-8981
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2025
Last Update Date : 09/15/2025

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Directions to “ KATHRYN RILEY ” Practice Location

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