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General NPI Number Information
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NPI Number | 1174507487
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Entity Type | Individual
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Provider Name | MARYBETH RIVARD APRN
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Gender | Female
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | NP CARE LLC SIX CORPORATE DR SUITE 420
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City | SHELTON
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State | CT
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Zip | 06484-6270
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Country | US
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Telephone | 203-925-9600
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Fax | 203-926-0594
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Provider Business Mailing Address
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Address Line | 84 WESTMORE RD
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City | CHESHIRE
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State | CT
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Zip | 06410-2014
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Country | US
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Telephone | 203-272-1734
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 002730
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License Number State | CT
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