Provider Demographics
NPI:1871250191
Name:RIVERA, ANNABELLE O (APRN FNP)
Entity Type:Individual
Prefix:
First Name:ANNABELLE
Middle Name:O
Last Name:RIVERA
Suffix:
Gender:F
Credentials:APRN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 N M ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-6554
Mailing Address - Country:US
Mailing Address - Phone:432-684-5541
Mailing Address - Fax:
Practice Address - Street 1:307 N M ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6554
Practice Address - Country:US
Practice Address - Phone:432-684-4451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059237363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily