Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1104329739 |
---|---|
Provider Name | Devon Charlotte Riley |
First Address | Steamboat Springs, CO 80487-9530 |
Second Address | Northampton, MA 01060-2052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2018 |
Last Update Date | 09/03/2018 |