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NPI Code Detail

MEDICARE: MARY J RILEY BSN

MEDICARE: MARY J RILEY BSN
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
1163WC1500XCommunity Health Registered NurseRN059857AZ

General Provider Information

NPI Number : 1194807826
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY J RILEY BSN
Provider Business Mailing Address
First Line : 515 SHOSHONE CIR
Second Line :
City : ELKO
State : NV
Zip : 89801-5072
Country : US
Telephone Number : 775-738-2252
Fax Number : 775-778-0521
Provider Business Practice Location Address
First Line : 515 SHOSHONE CIR
Second Line :
City : ELKO
State : NV
Zip : 89801-5072
Country : US
Telephone Number : 775-738-2252
Fax Number : 775-778-0521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 07/08/2007

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Directions to “ MARY J RILEY BSN” Practice Location

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