Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | ARNP9322150 | FL |
NPI | 1033500293 |
---|---|
Provider Name | Katrina Riley |
First Address | Tampa, FL 33611-4750 |
Second Address | Tampa, FL 33609-2564 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2015 |
Last Update Date | 10/02/2015 |