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General NPI Number Information
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NPI Number | 1689459448
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Entity Type | Individual
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Provider Name | JERICA LYNN RILEY APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/30/2023
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 231 MIDLAND PARK
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City | SHELBYVILLE
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State | KY
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Zip | 40065-9735
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Country | US
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Telephone | 502-633-6411
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Fax | 502-633-6657
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Provider Business Mailing Address
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Address Line | 3716 VALLEY CREEK DR
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City | PENDLETON
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State | KY
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Zip | 40055-9706
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Country | US
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Telephone |
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 1148887
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4040060
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License Number State | KY
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