Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD447684 | PA |
N | 207VG0400X | Gynecologist | MD60529475 | WA |
NPI | 1003042680 |
---|---|
Provider Name | Kristin A Riley |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033-2008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2009 |
Last Update Date | 02/09/2020 |