Individual
MRS. NICOLE T RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.,C.
Contact information
Practice address
900 TOWNE LAKE PKWY, SUITE 308, WOODSTOCK, GA 30189-1602
(770) 926-5459
(770) 926-4421
Mailing address
1355 PEACHTREE ST NE, SUITE 1600, ATLANTA, GA 30309-3212
(678) 223-7774
(678) 223-7799
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
005226
GA
Other
Enumeration date
05/01/2008
Last updated
04/19/2017
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