Provider Demographics
NPI:1669282182
Name:RILEY, TAKEIA LACHE (CNP)
Entity type:Individual
Prefix:MRS
First Name:TAKEIA
Middle Name:LACHE
Last Name:RILEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:TAKEIA
Other - Middle Name:LACHE
Other - Last Name:TRIPLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:2657 PEMBERTON DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-2904
Mailing Address - Country:US
Mailing Address - Phone:419-490-5448
Mailing Address - Fax:
Practice Address - Street 1:2657 PEMBERTON DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-2904
Practice Address - Country:US
Practice Address - Phone:419-490-5448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0038413363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner