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General NPI Number Information
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NPI Number | 1407447378
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Entity Type | Individual
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Provider Name | MONIQUE DANIELLE LARIVIERE AGACNP
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Gender | Female
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 65 CEDAR ST
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City | HYANNIS
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State | MA
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Zip | 02601-3009
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Country | US
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Telephone | 508-790-0611
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Fax |
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Provider Business Mailing Address
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Address Line | 621 MAIN ST
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City | WEST BARNSTABLE
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State | MA
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Zip | 02668-1128
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Country | US
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Telephone | 508-364-7734
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN10004785
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | R219303
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License Number State | MD
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