Jaclyn Riley, | |
2050 N Haggerty Rd Ste 200, Canton, MI 48187-3796 | |
(313) 550-3353 | |
Not Available |
Full Name | Jaclyn Riley |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Location | 2050 N Haggerty Rd Ste 200, Canton, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063000545 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 4704347010 (Michigan) | Primary |
Entity Name | Beaumont Medical Group- Specialty Services |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578072906 PECOS PAC ID: 7214299866 Enrollment ID: O20180320002549 |
Mailing Address | Practice Location Address |
---|---|
Jaclyn Riley, 1083 Beaconsfield Ave, Grosse Pointe Park, MI 48230-1346 Ph: (313) 550-3353 | Jaclyn Riley, 2050 N Haggerty Rd Ste 200, Canton, MI 48187-3796 Ph: (313) 550-3353 |
Lucinda Pryor, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1161 Stacy Dr, Canton, MI 48188 Phone: 313-740-5358 | |
Wendy Storey, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 49650 Cherry Hill Rd, Suite 210, Canton, MI 48187 Phone: 734-398-7899 Fax: 734-398-7895 | |
Molly Mcintyre, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 49650 Cherry Hill Rd, Suite 210, Canton, MI 48187 Phone: 734-398-7899 Fax: 734-398-7895 | |
Patricia Reckling, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 49650 Cherry Hill Rd, Suite 210, Canton, MI 48187 Phone: 734-398-7899 Fax: 734-398-7895 | |
Jennifer Martz, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6300 N Haggerty Rd, Suite Number 210, Canton, MI 48187 Phone: 734-641-3000 | |
Katelyn Marie Carey, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 45300 Lothrop Rd, Canton, MI 48188 Phone: 734-812-9895 |