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Individual

MISS KATHLEEN RIVERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1341 WALTER REED ROAD, FAYETTEVILLE, NC 28304
(910) 609-3500
(910) 321-6238
Mailing address
PO BOX 40908, FAYETTEVILLE, NC 28309-0908
(910) 609-6448
(910) 609-7040

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201363
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7003742
NC
Enumeration date
07/22/2005
Last updated
07/09/2007
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