Provider Demographics
NPI:1770835209
Name:RIVERA, ALMA (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 JUNIPER LN
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-1077
Mailing Address - Country:US
Mailing Address - Phone:972-492-2741
Mailing Address - Fax:
Practice Address - Street 1:4109 JUNIPER LN
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-1077
Practice Address - Country:US
Practice Address - Phone:972-492-2741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX705262163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant