Provider Demographics
NPI:1376017863
Name:RIVERS, NADIA K (LVN)
Entity Type:Individual
Prefix:MRS
First Name:NADIA
Middle Name:K
Last Name:RIVERS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 GREYFRIAR DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-6468
Mailing Address - Country:US
Mailing Address - Phone:810-252-3161
Mailing Address - Fax:
Practice Address - Street 1:3501 GREYFRIAR DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-6468
Practice Address - Country:US
Practice Address - Phone:810-252-3161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX346767164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse