Provider Demographics
NPI:1932540382
Name:RIVERA, STEFANIE LOUISE (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:LOUISE
Last Name:RIVERA
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:LOUISE
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4412 N MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2480
Mailing Address - Country:US
Mailing Address - Phone:832-474-7602
Mailing Address - Fax:956-668-0710
Practice Address - Street 1:4412 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2480
Practice Address - Country:US
Practice Address - Phone:832-474-7602
Practice Address - Fax:956-668-0710
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX730235363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily