Individual
GILMA LIZAIDA RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12520 FAIRWOOD PKWY, BOWIE, MD 20720-6343
(301) 262-2300
(844) 888-1044
Mailing address
12520 FAIRWOOD PKWY, BOWIE, MD 20720-6343
(301) 262-2300
(844) 888-1044
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R194206
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R194206
STATE LICENSE
MD
Enumeration date
08/11/2019
Last updated
11/15/2025
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