Provider Demographics
NPI:1336737477
Name:RILEY, CHRISTIUNA A (CPT)
Entity Type:Individual
Prefix:
First Name:CHRISTIUNA
Middle Name:A
Last Name:RILEY
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 DILLON HILL RD
Mailing Address - Street 2:
Mailing Address - City:TYLERTOWN
Mailing Address - State:MS
Mailing Address - Zip Code:39667-7604
Mailing Address - Country:US
Mailing Address - Phone:769-204-0075
Mailing Address - Fax:
Practice Address - Street 1:30 DILLON HILL RD
Practice Address - Street 2:
Practice Address - City:TYLERTOWN
Practice Address - State:MS
Practice Address - Zip Code:39667-7604
Practice Address - Country:US
Practice Address - Phone:769-204-0075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy