Provider Demographics
NPI:1689976920
Name:RIVERA-SANTIAGO, MICHELLE (CNM, WHNP)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:RIVERA-SANTIAGO
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 FOREST HILL BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6073
Mailing Address - Country:US
Mailing Address - Phone:561-651-9056
Mailing Address - Fax:561-509-7102
Practice Address - Street 1:1495 FOREST HILL BLVD STE D
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6073
Practice Address - Country:US
Practice Address - Phone:561-651-9056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9238414176B00000X
FLAPRN9238414363LW0102X, 367A00000X
NY001414367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health