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NPI Code Detail

MEDICARE: MISS RILEY COUNCIL B.A

MEDICARE: MISS RILEY COUNCIL B.A
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1194138388
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS RILEY COUNCIL B.A
Provider Business Mailing Address
First Line : 6621 COWBOY TRL
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-2915
Country : US
Telephone Number : 702-274-6167
Fax Number :
Provider Business Practice Location Address
First Line : 9183 W FLAMINGO RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-6464
Country : US
Telephone Number : 702-650-6508
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2014
Last Update Date : 06/05/2014

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Directions to “ MISS RILEY COUNCIL B.A” Practice Location

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