Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 01049854 | IN |
N | 207VE0102X | Reproductive Endocrinologist | 01049854 | IN |
N | 207VG0400X | Gynecologist | 01049854 | IN |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 01049854 | IN |
N | 207VX0000X | Obstetrician | 01049854 | IN |
NPI | 1093883159 |
---|---|
Provider Name | Christine M Riley |
First Address | Evansville, IN 47703-0359 |
Second Address | Evansville, IN 47714-0541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 27/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200206130 | (05) | IN |
64881899 | KY MEDICAID (01) | KY |
G85277 | (02) | IN |