MEDICARE: RHONDA 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	163W00000X	Registered Nurse	RN159525	GA

General Provider Information

NPI Number	:	1235500521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA RILEY

Provider Business Mailing Address
First Line	:	122 GORDON COMMERCIAL DR STE C
Second Line	:
City	:	LAGRANGE
State	:	GA
Zip	:	30240-5754
Country	:	US
Telephone Number	:	706-845-4045
Fax Number	:	706-845-4367

Provider Business Practice Location Address
First Line	:	122 GORDON COMMERCIAL DR STE C
Second Line	:
City	:	LAGRANGE
State	:	GA
Zip	:	30240-5754
Country	:	US
Telephone Number	:	706-845-4045
Fax Number	:	706-845-4367

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

Provider Enumeration Date	:	10/12/2015
Last Update Date	:	01/25/2026

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Directions to “ RHONDA RILEY ” Practice Location

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