| Jacquetta Riley, | |
|
1550 Carolina Ave, Orangeburg, SC 29115-4944 | |
| (803) 533-5489 | |
| Not Available |
| Full Name | Jacquetta Riley |
|---|---|
| Gender | Female |
| Speciality | Licensed Practical Nurse |
| Location | 1550 Carolina Ave, Orangeburg, South Carolina |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245829928 | NPI | - | NPPES |
| NONE | Other | VACCINES | |
| 0511SC | Other | SC | VACCINATING |
| 000 | Other | 0000 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | P47848 (South Carolina) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jacquetta Riley, 1550 Carolina Ave, Orangeburg, SC 29115-4944 Ph: (803) 533-5489 | Jacquetta Riley, 1550 Carolina Ave, Orangeburg, SC 29115-4944 Ph: (803) 533-5489 |
Mrs. Bridgett Shavonne Burnett, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 785 Five Chop Rd, Orangeburg, SC 29115 Phone: 803-378-4635 | |
Matieth Nicole Preston, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 347 Lakeview Dr, Orangeburg, SC 29115 Phone: 803-747-8600 |