Individual
TINA RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
925 HIGHWAY VV, KENNETT, MO 63857-0071
(573) 888-5925
Mailing address
20 S SPRIGG ST, CAPE GIRARDEAU, MO 63703-6212
(573) 651-4177
(573) 388-4586
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
140803
MO
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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