Provider Demographics
NPI:1134894637
Name:RILEY, DAWN N
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:N
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 1:3472 BRIGHAM ST APT 5
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-1660
Mailing Address - Country:US
Mailing Address - Phone:517-770-6116
Mailing Address - Fax:
Practice Address - Street 1:3472 BRIGHAM ST APT 5
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-1660
Practice Address - Country:US
Practice Address - Phone:517-706-1162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant