Individual
MRS. LISA J RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
176 MCSWAIN DR, WEST COLUMBIA, SC 29169-4825
(803) 767-4465
Mailing address
9275 MEDICAL PLAZA DR STE F, NORTH CHARLESTON, SC 29406-9140
(803) 767-4465
(803) 767-4120
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25651
SC
363LF0000X
Family Nurse Practitioner
26NJ01032600
NJ
Other
Enumeration date
05/08/2020
Last updated
10/05/2022
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