Provider Demographics
NPI:1154160257
Name:RILEY, PATRICE J
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:J
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 1:2795 THOMASVILLE CT APT 1331
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-3010
Mailing Address - Country:US
Mailing Address - Phone:513-418-8621
Mailing Address - Fax:
Practice Address - Street 1:2795 THOMASVILLE CT APT 1331
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3010
Practice Address - Country:US
Practice Address - Phone:513-418-8621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant