Provider Demographics
NPI:1043859267
Name:WILLMAN, RILEY LYNN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:RILEY
Middle Name:LYNN
Last Name:WILLMAN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:20050 N CAVE CREEK RD APT 386
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-5436
Mailing Address - Country:US
Mailing Address - Phone:248-462-1456
Mailing Address - Fax:
Practice Address - Street 1:13860 N NORTHSIGHT BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3654
Practice Address - Country:US
Practice Address - Phone:602-734-0252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2021-09-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant