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General NPI Number Information
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NPI Number | 1417625187
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Entity Type | Individual
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Provider Name | STACY MARIE RIVERA RIVERA AG-ACNP
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Gender | Female
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 7 VANDERBILT PARK DR
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City | ASHEVILLE
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State | NC
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Zip | 28803-1700
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Country | US
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Telephone | 828-255-7776
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Fax |
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Provider Business Mailing Address
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Address Line | 7 VANDERBILT PARK DR
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City | ASHEVILLE
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State | NC
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Zip | 28803-1700
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Country | US
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Telephone | 352-474-9363
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 11035492
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License Number State | FL
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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 | 95011538
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95011538
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 11035492
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 5022525
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5022525
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License Number State | NC
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