Provider Demographics
NPI:1669848453
Name:RIVERA, MAITTE YAIMA (FNP)
Entity Type:Individual
Prefix:
First Name:MAITTE
Middle Name:YAIMA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 MEANDERING SPRING DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-4095
Mailing Address - Country:US
Mailing Address - Phone:281-816-6700
Mailing Address - Fax:
Practice Address - Street 1:3730 BARKER CYPRESS RD STE 400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3906
Practice Address - Country:US
Practice Address - Phone:281-816-6700
Practice Address - Fax:281-816-6701
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX811752163W00000X
TXAP128796363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily