Individual
RILEY LOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 MICHIGAN ST NE STE 1800, GRAND RAPIDS, MI 49503-2568
(616) 391-3933
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
20248618
MI
Other
Enumeration date
10/29/2024
Last updated
04/30/2025
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