Individual
SHANTELL RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3808 N 60TH ST, MILWAUKEE, WI 53216-2133
(414) 999-1117
Mailing address
3808 N 60TH ST, MILWAUKEE, WI 53216-2133
(414) 999-1117
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
159479-30
WI
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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