Individual
LYDIA H. RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1209 W TARGET RANGE RD, NOGALES, AZ 85621-2466
(520) 287-4747
(520) 285-3136
Mailing address
825 N GRAND AVE STE 100, NOGALES, AZ 85621-1061
(520) 761-2133
(520) 281-1112
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP5061
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
836331
—
AZ
Enumeration date
07/11/2013
Last updated
05/26/2022
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