NPI Code Detail JSON Logo

1417625187 NPI number — STACY MARIE RIVERA RIVERA AG-ACNP

NPI Number: 1417625187
Health Care Provider/Practitioner: STACY MARIE RIVERA RIVERA AG-ACNP

Information about “1417625187” NPI (STACY MARIE RIVERA RIVERA AG-ACNP) exists in 1417625187 in HTML format HTML  |  1417625187 in plain Text format TXT  |  1417625187 in PDF (Portable Document Format) PDF  |  1417625187 in an XML format XML  formats.

NPI Number : 1417625187 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417625187",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RIVERA RIVERA",
    "FirstName": "STACY",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "AG-ACNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "TORRES",
    "OtherFirstName": "STACY",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "AG-ACNP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "7 VANDERBILT PARK DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ASHEVILLE",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28803-1700",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "352-474-9363",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7 VANDERBILT PARK DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ASHEVILLE",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28803-1700",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "828-255-7776",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/30/2021",
    "LastUpdateDate": "08/13/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "11035492",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "95011538",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "95011538",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "11035492",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LG0600X",
          "TaxonomyName": "Gerontology Nurse Practitioner",
          "LicenseNumber": "5022525",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "5022525",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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