Individual
MRS. DARLA K RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
7111 E 21ST STREET N, SUITE A, WICHITA, KS 67206
(316) 684-2851
(316) 686-7338
Mailing address
7111 E 21ST STREET N, SUITE A, WICHITA, KS 67206
(316) 684-2851
(316) 686-7338
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-22566
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100231360B
MEDICAID INDIVIDUAL
KS
05
—
100416440A
—
KS
01
—
101599
BLUE CROSS INDIVIDUAL
KS
01
—
110718
BLUE CROSS GROUP
KS
01
—
622091
FIRSTGUARD
KS
01
—
80186349
RAILROAD MEDICARE
KS
Enumeration date
07/22/2005
Last updated
10/16/2012
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