Maryanne Riley, FNP
Individual provider Active NPI Nurse Practitioner · Redway, CA
NPI 1700950276 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1700950276
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- NP10234 (CA)
- Practice address
- 101 Westcoast Rd
Redway, CA 95560 - Phone
- (707) 923-2783
- Fax
- (707) 923-2543
- NPI assigned
- Nov 17, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10234 | CA | MD | Physical Therapist |
| NP10234 | CA | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP10234 | CA | Yes |
Addresses
Primary practice location
101 Westcoast Rd
Redway, CA 95560
Mailing address
PO Box 769 101 Westcoast Rd
Redway, CA 95560
Phone (707) 923-2783
Other providers in Redway, CA
- Gelareh Rahbar
- Redwoods Rural Health Center Inc.
- Redwoods Rural Health Center, Inc
- Redwoods Rural Health Center, Inc.
- Redwoods Rural Health Center, Inc.
- Andrea Rodrigo
- Philip Scheel
- Suraj Prasad Sinha
- Crystal Dawn Wansick
- Kelly Ward
All providers in Redway, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.