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Individual

LORRAINE RIVERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
420 POLIFKA DR, SHAW AFB, SC 29152-5100
(843) 895-6449
Mailing address
420 POLIFKA DR, SHAW AFB, SC 29152-5100
(803) 895-6356

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN.21613
SC

Other

Enumeration date
11/13/2018
Last updated
02/25/2026
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