Individual
ANN GIRLIE RIVERA TKACZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
173 DANIEL WEBSTER HWY, NASHUA, NH 03060-5256
(603) 891-4500
(603) 891-4414
Mailing address
C/O ST MARY'S HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8695
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
040723-23
NH
363LF0000X
Family Nurse Practitioner
RN225861
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3075218
—
NH
Enumeration date
04/09/2009
Last updated
11/08/2019
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