Individual
DENISE RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(478) 538-0908
Mailing address
PO BOX 1459, MINNEAPOLIS, MN 55440-1459
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
003448
CT
363LA2200X
Adult Health Nurse Practitioner
Primary
003448
CT
363LA2200X
Adult Health Nurse Practitioner
0991579
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004263505
—
CT
Enumeration date
08/23/2006
Last updated
08/03/2020
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