Individual
JENNIFER J. RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5700 BOTTINEAU BLVD, SUITE 100, CRYSTAL, MN 55429-3183
(763) 504-6500
Mailing address
5700 BOTTINEAU BLVD, SUITE 100, CRYSTAL, MN 55429-3183
(763) 504-6500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50322
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P01192299
—
MN
Enumeration date
04/16/2008
Last updated
11/19/2013
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