Provider Demographics
NPI:1811449358
Name:RILEY, CHELSEA MAE (CNM)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MAE
Last Name:RILEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 BAY PARK DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-4921
Mailing Address - Country:US
Mailing Address - Phone:419-690-8882
Mailing Address - Fax:
Practice Address - Street 1:2751 BAY PARK DR
Practice Address - Street 2:SUITE 300
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-4921
Practice Address - Country:US
Practice Address - Phone:419-690-8882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704297244163W00000X, 176B00000X
OHRN.432578163W00000X
OHAPRN.CNM.019318367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No176B00000XOther Service ProvidersMidwife