Provider Demographics
NPI:1922834076
Name:RILEY, WENDY L
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:RILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 BARBARA HEIGHTS DR APT 102
Mailing Address - Street 2:
Mailing Address - City:SHINNSTON
Mailing Address - State:WV
Mailing Address - Zip Code:26431-1456
Mailing Address - Country:US
Mailing Address - Phone:304-709-8917
Mailing Address - Fax:
Practice Address - Street 1:809 BARBARA HEIGHTS DR APT 102
Practice Address - Street 2:
Practice Address - City:SHINNSTON
Practice Address - State:WV
Practice Address - Zip Code:26431-1456
Practice Address - Country:US
Practice Address - Phone:304-709-8917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty