Healthcare Provider Details

I. General information

NPI: 1366380644
Provider Name (Legal Business Name): RHIANA NICHOLE RIVAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GRESHAM DR
NORFOLK VA
23507-1904
US

IV. Provider business mailing address

100 BROADWAY BLVD NE APT 306
ALBUQUERQUE NM
87102-3419
US

V. Phone/Fax

Practice location:
  • Phone: 757-446-8950
  • Fax:
Mailing address:
  • Phone: 505-977-4277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: