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General NPI Number Information
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NPI Number | 1558286096
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Entity Type | Individual
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Provider Name | RILEY HUMBERSTONE PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 2111 DREW ST STE 200
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City | CLEARWATER
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State | FL
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Zip | 33765-3215
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Country | US
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Telephone | 727-447-4536
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Fax |
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Provider Business Mailing Address
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Address Line | 11201 122ND AVE APT 225
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City | LARGO
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State | FL
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Zip | 33778-2631
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Country | US
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Telephone | 585-698-5409
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9122066
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License Number State | FL
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