| 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 |