Provider Demographics
NPI:1497041891
Name:RIVENBARK, VIRGINIA SUE (CD)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:SUE
Last Name:RIVENBARK
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-2102
Mailing Address - Country:US
Mailing Address - Phone:570-380-0150
Mailing Address - Fax:
Practice Address - Street 1:231 E 10TH ST
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-2102
Practice Address - Country:US
Practice Address - Phone:570-380-0150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula