Provider Demographics
NPI:1942904131
Name:RIVERS, BRIONNA NICOLE
Entity Type:Individual
Prefix:
First Name:BRIONNA
Middle Name:NICOLE
Last Name:RIVERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14901 HUMMEL RD APT 7
Mailing Address - Street 2:
Mailing Address - City:BROOKPARK
Mailing Address - State:OH
Mailing Address - Zip Code:44142-2046
Mailing Address - Country:US
Mailing Address - Phone:216-294-8333
Mailing Address - Fax:
Practice Address - Street 1:14901 HUMMEL RD APT 7
Practice Address - Street 2:
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-2046
Practice Address - Country:US
Practice Address - Phone:216-294-8333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health