Elizabeth J. Riley, CNP

Individual provider Active NPI Family Nurse Practitioner · Bolton, MA

NPI 1891024675 · NPPES record last updated Oct 9, 2024

Key facts

NPI
1891024675
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN262315 (MA)
Practice address
1092 Main St Unit 2
Bolton, MA 01740-1265
Phone
(978) 868-8114
Fax
(774) 374-8032
NPI assigned
Dec 8, 2009
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
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN263315MAMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN263315 MA
Family Nurse Practitioner 363LF0000X RN262315 MA Yes

Addresses

Primary practice location

1092 Main St Unit 2
Bolton, MA 01740-1265

Mailing address

58 Laurel LN
Lunenburg, MA 01462-2028
Phone (978) 833-0507

Other identifiers

IdentifierTypeStateIssuer
110117903AMedicaidMA

Other providers in Bolton, MA

All providers in Bolton, MA · Family Nurse Practitioner in Massachusetts

Sources for this page

Verify at the official NPI Registry.