Provider Demographics
NPI:1780097691
Name:RILES, JAMIE LEE (FNP-C)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:RILES
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 910530
Mailing Address - Street 2:ELIZABETHTOWN EMERGENCY PHYSICIANS
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-0530
Mailing Address - Country:US
Mailing Address - Phone:877-783-6257
Mailing Address - Fax:859-514-5521
Practice Address - Street 1:914 N. DIXIE HIGHWAY
Practice Address - Street 2:SPERO HEALTH OF KENTUCKY, LLC
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701
Practice Address - Country:US
Practice Address - Phone:270-706-1642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008684363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health