MEDICARE: CRISTAL 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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1558203281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTAL RILEY

Provider Business Mailing Address
First Line	:	5516 SUPERIOR DR STE A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-8022
Country	:	US
Telephone Number	:	225-888-5881
Fax Number	:	225-888-5881

Provider Business Practice Location Address
First Line	:	5516 SUPERIOR DR STE A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-8022
Country	:	US
Telephone Number	:	225-888-5881
Fax Number	:	225-888-5881

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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Directions to “ CRISTAL RILEY ” Practice Location

Language	Start Address	Practice Location

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