Individual
STACIA A RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2165 WHITE BEAR AVE - MAIL STOP 31600A, HEALTHPARTNERS MAPLEWOOD CLINIC, MAPLEWOOD, MN 55109
(651) 523-9800
(651) 523-9801
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516
(651) 523-9800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
46839
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0450916
—
IA
Enumeration date
08/24/2006
Last updated
08/22/2018
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