Provider Demographics
NPI:1841962552
Name:RIVAS, ELFEDA B (RN BSN MAED PHD)
Entity type:Individual
Prefix:
First Name:ELFEDA
Middle Name:B
Last Name:RIVAS
Suffix:
Gender:F
Credentials:RN BSN MAED PHD
Other - Prefix:
Other - First Name:ELFEDA
Other - Middle Name:B
Other - Last Name:RIVAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN BSN MAED PHD
Mailing Address - Street 1:505 S MAIN ST STE 249
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-1243
Mailing Address - Country:US
Mailing Address - Phone:575-527-5823
Mailing Address - Fax:575-527-5886
Practice Address - Street 1:505 S MAIN ST STE 249
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-1243
Practice Address - Country:US
Practice Address - Phone:575-527-5823
Practice Address - Fax:575-527-5886
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR22708163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool