Provider Demographics
NPI:1407154891
Name:RIVARD, MARIA J (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:J
Last Name:RIVARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3359 E COMSTOCK DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1890
Mailing Address - Country:US
Mailing Address - Phone:480-275-6119
Mailing Address - Fax:
Practice Address - Street 1:9430 E NEVILLE AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-1500
Practice Address - Country:US
Practice Address - Phone:480-635-2011
Practice Address - Fax:480-635-2020
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN163869163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse