Healthcare Provider Details

I. General information

NPI: 1477739142
Provider Name (Legal Business Name): BRENDA ANN RIVERA RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2008
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6015 E BROWN RD
MESA AZ
85205-4452
US

IV. Provider business mailing address

6015 E BROWN RD
MESA AZ
85205-4452
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 866-389-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP2882
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95009767
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: