Individual
MARYELLEN AGNES RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WHNP, RN,C, MS
Contact information
Practice address
1252 N 22ND ST UNIT A, LARAMIE, WY 82072
(307) 745-5364
(307) 745-4164
Mailing address
1252 N 22ND ST UNIT A, LARAMIE, WY 82072-5306
(307) 745-5364
(307) 745-4164
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
102244
CO
363LW0102X
Women's Health Nurse Practitioner
Primary
41390.1753
WY
Other
Enumeration date
03/22/2009
Last updated
06/25/2018
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