Individual provider · Type 1 NPI

Jaclyn Riley

Nurse Practitioner · Canton, MI

NPI number 1063000545 Active

Practice location

2050 N Haggerty Rd Ste 200
Canton, MI 48187-3796

Call (313) 550-3353 Map

Mailing address

1083 Beaconsfield Ave
Grosse Pointe Park, MI 48230-1346

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X4704347010 (MI)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1063000545

Jaclyn Riley's National Provider Identifier is 1063000545, issued on Jan 9, 2021. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Canton, MI. The record was last updated on Sep 29, 2023.