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General NPI Number Information
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NPI Number | 1033678024
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Entity Type | Individual
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Provider Name | JAIME LYN RILEY
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Gender | Female
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 660 BEAVER CREEK CIR STE 200
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City | MAUMEE
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State | OH
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Zip | 43537-1746
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Country | US
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Telephone | 419-891-6201
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Fax | 419-893-1227
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Provider Business Mailing Address
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Address Line | 7557B DANNAHER DR STE 225
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City | POWELL
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State | TN
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Zip | 37849-3568
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Country | US
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Telephone | 865-647-3450
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 34.018266
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | DO5092
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License Number State | TN
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