1881020402 NPI number — DONNA LYNN RIVERA APN, CNM

Table of content: DONNA LYNN RIVERA APN, CNM (NPI 1881020402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881020402 NPI number — DONNA LYNN RIVERA APN, CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIVERA
Provider First Name:
DONNA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APN, CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOLDSCHMIDT, HORNBECK, BOSLEY
Provider Other First Name:
DONNA
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881020402
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/24/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1125 S ALMA SCHOOL RD STE 210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85286-2811
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
623-248-2106
Provider Business Mailing Address Fax Number:
480-526-8387

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1125 S ALMA SCHOOL RD STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85286-2811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-684-5077
Provider Business Practice Location Address Fax Number:
480-526-8387
Provider Enumeration Date:
09/16/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X , with the licence number:  209010714 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367A00000X , with the licence number: 209010714 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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