Individual
MS. MAYRA IVETTE RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
375 WAMPANOAG TRL, RIVERSIDE, RI 02915-2232
(401) 649-4090
(401) 649-4091
Mailing address
15 LA SALLE SQ, PROVIDENCE, RI 02903-1814
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN02802
RI
363LF0000X
Family Nurse Practitioner
Primary
APRN02802
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427714096
—
RI
Enumeration date
11/09/2021
Last updated
03/05/2026
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