MEDICARE: MS. KATHLEEN MEGAN RILEY CNM

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	367A00000X	Advanced Practice Midwife	101.0134922	VT
2	367A00000X	Advanced Practice Midwife	067625-23	NH
3	367A00000X	Advanced Practice Midwife	CNM122007	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144556663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN MEGAN RILEY CNM

Provider Business Mailing Address
First Line	:	570 EGG HARBOR RD
Second Line	:	SUITE C-2
City	:	SEWELL
State	:	NJ
Zip	:	08080-2359
Country	:	US
Telephone Number	:	856-218-0300
Fax Number	:	856-589-9487

Provider Business Practice Location Address
First Line	:	570 EGG HARBOR RD
Second Line	:	SUITE C-2
City	:	SEWELL
State	:	NJ
Zip	:	08080-2359
Country	:	US
Telephone Number	:	856-218-0300
Fax Number	:	856-589-9487

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

Provider Enumeration Date	:	10/19/2009
Last Update Date	:	05/13/2026

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