Healthcare Provider Details

I. General information

NPI: 1144040460
Provider Name (Legal Business Name): NOAH MICHAEL RILEY FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 HODGSON MEMORIAL DR STE 5
SAVANNAH GA
31406-2549
US

IV. Provider business mailing address

7001 HODGSON MEMORIAL DR STE 5
SAVANNAH GA
31406-2549
US

V. Phone/Fax

Practice location:
  • Phone: 912-208-9773
  • Fax: 833-973-3544
Mailing address:
  • Phone: 912-208-9773
  • Fax: 912-500-2852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP299981
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN299981
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: