Provider Demographics
NPI:1205980612
Name:RIVARD, CLAUDIA RENEE (LPN)
Entity type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:RENEE
Last Name:RIVARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:CLAUDIA
Other - Middle Name:RENEE
Other - Last Name:POULIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:58 STAGE RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03037-1607
Mailing Address - Country:US
Mailing Address - Phone:603-463-9018
Mailing Address - Fax:
Practice Address - Street 1:58 STAGE RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:NH
Practice Address - Zip Code:03037-1607
Practice Address - Country:US
Practice Address - Phone:603-463-9018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH010321-22164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse