Provider Demographics
NPI:1821896416
Name:RIVERS, TI' MONIE R
Entity type:Individual
Prefix:
First Name:TI' MONIE
Middle Name:R
Last Name:RIVERS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10808 PRATT PLZ APT A15
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-2959
Mailing Address - Country:US
Mailing Address - Phone:402-709-1033
Mailing Address - Fax:
Practice Address - Street 1:10808 PRATT PLZ APT A15
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-2959
Practice Address - Country:US
Practice Address - Phone:402-709-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care