Individual
PROF. MARILYN J. RILEY
Active
Individual
PROF. MARILYN J. RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71000828A
IN
363LF0000X
Family Nurse Practitioner
71000828A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001126642
ANTHEM PROVIDER NUMBER
IN
05
—
200843250
—
IN
Enumeration date
11/09/2005
Last updated
03/17/2018
Update your record
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