Riley Queensland

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Grand Meadow, MN

NPI 1043130669 · NPPES record last updated Jul 16, 2026

Key facts

NPI
1043130669
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
514 1St Ave SE
Grand Meadow, MN 55936-1400
Phone
(507) 951-5244
NPI assigned
Jul 16, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

514 1St Ave SE
Grand Meadow, MN 55936-1400

Mailing address

514 1St Ave SE
Grand Meadow, MN 55936-1400

Other providers in Grand Meadow, MN

All providers in Grand Meadow, MN · Student in an Organized Health Care Education/Training Program in Minnesota

Sources for this page

Verify at the official NPI Registry.