Individual
TAMARA JEAN RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
111 PARK AVE, BALTIMORE, MD 21201-3402
(410) 837-5533
(410) 837-2168
Mailing address
1804 MAXWELL AVE, DUNDALK, MD 21222-2912
(410) 284-6823
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP26514
MD
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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