Individual
MARY KATHRYN RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
1022 GREYSTONE SQ, JACKSON, TN 38305-3580
(731) 300-2001
(731) 240-8095
Mailing address
371 N PARKWAY STE 400, JACKSON, TN 38305-2891
(731) 664-0002
(731) 664-7859
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
188898
TN
363L00000X
Nurse Practitioner
Primary
30228
TN
Other
Enumeration date
08/02/2021
Last updated
09/03/2021
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