Provider Demographics
NPI:1407876923
Name:RILEY, ERIKA LYNN (OTR)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:LYNN
Last Name:RILEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:FENTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:3001 EDWARDS MILL RD
Mailing Address - Street 2:# 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5243
Mailing Address - Country:US
Mailing Address - Phone:919-863-6872
Mailing Address - Fax:919-781-5246
Practice Address - Street 1:3001 EDWARDS MILL RD
Practice Address - Street 2:# 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5243
Practice Address - Country:US
Practice Address - Phone:919-863-6872
Practice Address - Fax:919-781-5246
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9903225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH13Y008854NH01OtherBLUE SHIELD NH
NH5154598OtherCIGNA