Healthcare Provider Details

I. General information

NPI: 1306715917
Provider Name (Legal Business Name): JASMINE RIVERA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 PRINTERS PKWY
COLORADO SPRINGS CO
80910-3190
US

IV. Provider business mailing address

3205 N ACADEMY BLVD STE 130
COLORADO SPRINGS CO
80917-5152
US

V. Phone/Fax

Practice location:
  • Phone: 719-632-5700
  • Fax:
Mailing address:
  • Phone: 716-632-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN.1653674
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1002115-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: