Provider Demographics
NPI:1518206325
Name:RIVERA, JULIE M (CNA)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:M
Last Name:RIVERA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14583 SUSSEX HWY
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19933-2973
Mailing Address - Country:US
Mailing Address - Phone:302-393-4347
Mailing Address - Fax:
Practice Address - Street 1:14583 SUSSEX HWY
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:DE
Practice Address - Zip Code:19933-2973
Practice Address - Country:US
Practice Address - Phone:302-393-4347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDE0000007685376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide