Provider Demographics
NPI:1972606994
Name:RIVERA, JANET C (RN)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:C
Last Name:RIVERA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ST CONSULADO G16 URB PASEO REAL
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-0000
Mailing Address - Country:US
Mailing Address - Phone:787-812-3030
Mailing Address - Fax:787-651-4334
Practice Address - Street 1:ST CONSULADO G16 URB PASEO REAL
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-0000
Practice Address - Country:US
Practice Address - Phone:787-812-3030
Practice Address - Fax:787-651-4334
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR013331163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR013331OtherRN