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NPI 1841538030

NPI 1841538030 : AMBER S RILEY CNP : PHILADELPHIA, MS

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General NPI Number Information
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    NPI Number           |    1841538030
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    Entity Type          |    Individual 
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    Provider Name        |    AMBER S RILEY CNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/22/2013
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    Last Update Date     |    07/22/2015
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Provider Practice Location Address
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    Address Line         |    10330 ROAD 375 
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    City                 |    PHILADELPHIA
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    State                |    MS
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    Zip                  |    39350-3249
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    Country              |    US
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    Telephone            |    601-656-0226
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    Fax                  |    601-389-6759
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Provider Business Mailing Address
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    Address Line         |    10330 ROAD 375 
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    City                 |    PHILADELPHIA
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    State                |    MS
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    Zip                  |    39350-3249
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    Country              |    US
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    Telephone            |    601-656-0226
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    Fax                  |    601-389-6759
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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        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    R877207
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    License Number State |    MS
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