Individual
MICHELLE RAE RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10631 S 51ST ST STE 8, PHOENIX, AZ 85044-5225
(480) 418-7246
Mailing address
10901 E PUEBLO AVE, MESA, AZ 85208-3907
(480) 467-8169
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RN158234
AZ
363LF0000X
Family Nurse Practitioner
Primary
265613
AZ
Other
Enumeration date
08/28/2021
Last updated
06/25/2024
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