Provider Demographics
NPI:1356585624
Name:RIVERA, JENNIFER CARNEY (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CARNEY
Last Name:RIVERA
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1332 DE SOTO ST
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-7070
Mailing Address - Country:US
Mailing Address - Phone:321-408-6925
Mailing Address - Fax:321-701-0343
Practice Address - Street 1:1332 DE SOTO ST
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-7070
Practice Address - Country:US
Practice Address - Phone:321-408-6925
Practice Address - Fax:321-701-0343
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9219868363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner