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General NPI Number Information
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NPI Number | 1801528765
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Entity Type | Individual
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Provider Name | MELISSA GRACE RILEY CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 135 MEDICAL PARK DR STE 2B
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City | ANDALUSIA
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State | AL
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Zip | 36420-5352
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Country | US
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Telephone | 855-527-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 14703 MADDOX RD
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City | ANDALUSIA
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State | AL
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Zip | 36420-6532
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Country | US
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Telephone | 334-488-4808
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-145931
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License Number State | AL
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