Healthcare Provider Details

I. General information

NPI: 1952221350
Provider Name (Legal Business Name): NAHMINA RILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20872 ATLANTIC AVE
WARREN MI
48091-2872
US

IV. Provider business mailing address

20872 ATLANTIC AVE
WARREN MI
48091-2872
US

V. Phone/Fax

Practice location:
  • Phone: 248-636-7337
  • Fax:
Mailing address:
  • Phone: 248-636-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number5303049531
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: