Individual
NICOLE RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 RALPH MCGILL BLVD NE UNIT 509, ATLANTA, GA 30312-1197
(802) 595-1933
Mailing address
720 RALPH MCGILL BLVD NE UNIT 509, ATLANTA, GA 30312-1197
(802) 595-1933
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
12928
GA
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/25/2023
Last updated
06/11/2025
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