Individual
LATRICIA SANDAU RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
615 7TH AVE, BOWLING GREEN, KY 42101-6921
(270) 783-3573
Mailing address
615-7TH AVENUE, PO BOX 1177, BOWLING GREEN, KY 42102-1177
(270) 783-3573
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3010223
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100410770
—
KY
Enumeration date
04/06/2016
Last updated
12/01/2016
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