Healthcare Provider Details

I. General information

NPI: 1154285252
Provider Name (Legal Business Name): ANISAH RILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 EAST ST
WILKINSBURG PA
15221-2464
US

IV. Provider business mailing address

1117 EAST SREET
WILKINSBURG PA
15221
US

V. Phone/Fax

Practice location:
  • Phone: 412-628-3469
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP034759
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: