Individual
CHARISSE LENELL RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9991 MARSH LN, DALLAS, TX 75220-1766
(214) 358-0090
(214) 358-0760
Mailing address
9991 MARSH LN, DALLAS, TX 75220-1766
(214) 358-0090
(214) 526-6851
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
522465
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042485504
—
TX
05
—
042485506
—
TX
Enumeration date
03/18/2006
Last updated
11/23/2015
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