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Individual

MRS. JENNIFER LYNN RIVENBURGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-P

Contact information

Practice address
11-21 BROADWAY ST, GLOVERSVILLE, NY 12078-3964
(518) 725-4310
(518) 725-2988
Mailing address
11-21 BROADWAY ST, GLOVERSVILLE, NY 12078-3964
(518) 725-4310
(518) 725-2988

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
720511
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402794
NY

Other

Enumeration date
06/27/2019
Last updated
09/25/2019
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