Individual provider · NPI-1

Mercedes Chanel Riley, RN

Registered Nurse, General Practice · Lakeland, FL

NPI number1104405877
StatusActive
Last updated in NPPESApr 7, 2021

Details

NPI
1104405877
Entity type
Individual (NPI-1)
Name
Mercedes Chanel Riley
Credential
RN
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 7, 2021
Certification date
Apr 7, 2021
Last updated
Apr 7, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice9321297FLYes

Practice location

1041 W Chase St
Lakeland, FL 33815-1353

Phone 863-510-1685

Mailing address

1041 W Chase St
Lakeland, FL 33815-1353

Phone 863-510-1685

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