Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 251009 | MA |
N | 363LP2300X | Nurse Practitioner - Primary Care | R164675 | MD |
NPI | 1073822797 |
---|---|
Provider Name | Ms. Karen Lynn Riley |
First Address | Holden, MA 01520-1424 |
Second Address | Holden, MA 01520-1424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2010 |
Last Update Date | 21/11/2016 |