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General NPI Number Information
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NPI Number | 1386616423
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Entity Type | Individual
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Provider Name | KAREN LYNNE RIVERS CSA
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Gender | Female
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2800 GODWIN BLVD
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City | SUFFOLK
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State | VA
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Zip | 23434-8038
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Country | US
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Telephone | 757-934-4623
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Fax | 757-934-4114
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Provider Business Mailing Address
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Address Line | 5041 HUNT CLUB CHASE
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City | SUFFOLK
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State | VA
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Zip | 23435-3225
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Country | US
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Telephone | 757-638-9315
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Fax | 757-934-4114
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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