Healthcare Provider Details

I. General information

NPI: 1235353517
Provider Name (Legal Business Name): AISHA RACHELLE RILEY APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 12/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 MASSACHUSETTS AVE NW
WASHINGTON DC
20036-1011
US

IV. Provider business mailing address

5725 3RD PL NW
WASHINGTON DC
20011-2104
US

V. Phone/Fax

Practice location:
  • Phone: 202-785-1836
  • Fax: 202-722-0169
Mailing address:
  • Phone: 202-785-1836
  • Fax: 202-722-0169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN1010245
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1010245
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: