Individual
MELISSA DAWN RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
HC 75 BOX 49A, CHAMA, NM 87520-9701
(505) 759-7228
Mailing address
HC 75 BOX 49A, CHAMA, NM 87520-9701
(505) 759-7228
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000K3526
—
NM
01
—
HSZ196
MEDICARE PART B
NM
Enumeration date
10/25/2006
Last updated
05/27/2008
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