Provider Demographics
NPI:1821359183
Name:RIVERA, APRIL M (PA-C)
Entity Type:Individual
Prefix:MS
First Name:APRIL
Middle Name:M
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:APRIL
Other - Middle Name:M
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 95590
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87199-5590
Mailing Address - Country:US
Mailing Address - Phone:505-503-3513
Mailing Address - Fax:
Practice Address - Street 1:7000 JEFFERSON ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4313
Practice Address - Country:US
Practice Address - Phone:505-344-9478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2012-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA2012-0016363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical