Basic Information
| Provider Information | |||||||||
| NPI: | 1518370642 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RILLEY | ||||||||
| FirstName: | VERNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1712 NW 23RD AVE | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344755219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526153866 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1601 SW ARCHER RD | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326081135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525486000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2014 | ||||||||
| LastUpdateDate: | 06/05/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1710I1003X | N | Other Service Providers | Military Health Care Provider | Independent Duty Medical Technicians | 246ZS0410X | 142245 | TX | N | 374U00000X | CNA 98256 | FL | N | Nursing Service Related Providers | Home Health Aide | 376K00000X | CNA 98256 | FL | Y | Nursing Service Related Providers | Nurse's Aide |
No ID Information.