Healthcare Provider Details

I. General information

NPI: 1487329728
Provider Name (Legal Business Name): DEVEN RILEY FNP-BC, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1539 W BROAD ST
COLUMBUS OH
43222-1078
US

IV. Provider business mailing address

5888 CLEVELAND AVE
COLUMBUS OH
43231-2860
US

V. Phone/Fax

Practice location:
  • Phone: 614-882-4343
  • Fax: 614-882-4664
Mailing address:
  • Phone: 614-882-4343
  • Fax: 614-882-4664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2021036374
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025074205
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0029335
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: