Organization
KIMBERLY A RIVERA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY A RIVERA FNP (NURSE PRACTITIONER)
(985) 640-1043
Entity
Organization
Contact information
Practice address
126 PONTCHARTRAIN OAKS DR, MADISONVILLE, LA 70447-9642
(985) 974-1149
Mailing address
5032 HOUSE SPARROW DR, MADISONVILLE, LA 70447-3032
(985) 640-1043
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/21/2021
Last updated
08/15/2021
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