Healthcare Provider Details

I. General information

NPI: 1295499507
Provider Name (Legal Business Name): ARIELLE NICOLE RIVERA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 MAPLE ST
DANVERS MA
01923-4009
US

IV. Provider business mailing address

450 MAPLE ST # 4HC
DANVERS MA
01923-4009
US

V. Phone/Fax

Practice location:
  • Phone: 646-732-5084
  • Fax:
Mailing address:
  • Phone: 978-774-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2317360
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2317360
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: