Maryellen Agnes Riley, WHNP, RN,C, MS

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

41390.1753 Issued in WY

Practice address

1252 N 22ND St Unit a
Laramie, WY 82072

Phone

(307) 745-5364

Fax

(307) 745-4164

NPI assigned

Mar 22, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1346481389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 N 22ND ST UNIT A",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820725306",
            "telephone_number": "307-745-5364",
            "fax_number": "307-745-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 N 22ND ST UNIT A",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "82072",
            "telephone_number": "307-745-5364",
            "fax_number": "307-745-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "MARYELLEN",
        "middle_name": "AGNES",
        "credential": "WHNP, RN,C, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-22",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CO",
            "license": "102244",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WY",
            "license": "41390.1753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kenneth L Robertson, MD FACP

• Women's Health Nurse Practitioner in Laramie, WY
• Providers in Laramie, WY by specialty
• Women's Health Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.