Individual
MARY RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1502 S COLORADO ST, GREENVILLE, MS 38703-7219
(662) 334-6448
Mailing address
PO BOX 374, RULEVILLE, MS 38771-0374
(662) 588-5614
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R882123
MS
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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