Provider Demographics
NPI:1336802115
Name:RIVERA, FLOR ANDREA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:FLOR
Middle Name:ANDREA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:FLOR
Other - Middle Name:ANDREA
Other - Last Name:RIVERA GONZALEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:915 TATE BLVD SE STE 182
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4042
Mailing Address - Country:US
Mailing Address - Phone:828-322-2005
Mailing Address - Fax:828-322-2159
Practice Address - Street 1:915 TATE BLVD SE STE 182
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4042
Practice Address - Country:US
Practice Address - Phone:828-322-2005
Practice Address - Fax:828-322-2159
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015233363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily