MEDICARE: CHEYENNE RILEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1013788892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHEYENNE RILEY

Provider Business Mailing Address
First Line	:	421 MISSOURI AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45226-1334
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1228 LINCOLN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1349
Country	:	US
Telephone Number	:	513-208-9307
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2024
Last Update Date	:	03/04/2026

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Directions to “ CHEYENNE RILEY ” Practice Location

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