Healthcare Provider Details

I. General information

NPI: 1396233078
Provider Name (Legal Business Name): MEGAN C RILEY WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2018
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WOMANS WAY STE 407
BATON ROUGE LA
70817-5100
US

IV. Provider business mailing address

6244 SNOWDEN DR
BATON ROUGE LA
70817-3563
US

V. Phone/Fax

Practice location:
  • Phone: 225-215-7960
  • Fax:
Mailing address:
  • Phone: 225-276-6849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP09920
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: