Individual
LINDA RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1029 MEDICAL CENTER CIR, MAYFIELD, KY 42066-1189
(573) 686-5550
Mailing address
1029 MEDICAL CENTER CIR, MAYFIELD, KY 42066-1189
(573) 686-5550
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1047529
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000374954
KY BCBS IND
KY
01
—
000000525351
BCBS PROVIDER NUMBER
KY
05
—
74008772
—
KY
Enumeration date
03/05/2007
Last updated
12/07/2007
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