Provider Demographics
NPI:1073822797
Name:RILEY, KAREN LYNN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNN
Last Name:RILEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 SALISBURY ST
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1424
Mailing Address - Country:US
Mailing Address - Phone:443-989-8718
Mailing Address - Fax:
Practice Address - Street 1:554 SALISBURY STREET
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520-1424
Practice Address - Country:US
Practice Address - Phone:443-989-8718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR164675363LP2300X
MA251009363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care