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General NPI Number Information
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NPI Number | 1952947574
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Entity Type | Individual
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Provider Name | TERESIAH W. MWANGI-RILEY
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Gender | Female
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Dates
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Enumeration Date | 11/19/2019
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1901 W WESTERN AVE STE B
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City | SOUTH BEND
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State | IN
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Zip | 46619-3570
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Country | US
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Telephone | 574-234-9033
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Fax | 574-847-7200
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Provider Business Mailing Address
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Address Line | 8003 CASTLEWAY DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-1946
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Country | US
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Telephone | 317-576-1335
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Fax | 317-343-6562
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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 | 71009551A
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License Number State | IN
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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 | 71009551A
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License Number State | IN
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