MEDICARE: MRS. RAQUEL IVET RIVAS FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP10626	AZ

General Provider Information

NPI Number	:	1154832574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RAQUEL IVET RIVAS FNP-C

Provider Business Mailing Address
First Line	:	4110 N 108TH AVE STE 105
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85037-5772
Country	:	US
Telephone Number	:	623-772-6999
Fax Number	:	623-772-6444

Provider Business Practice Location Address
First Line	:	4110 N 108TH AVE STE 105
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85037-5772
Country	:	US
Telephone Number	:	623-772-6999
Fax Number	:	623-772-6444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2017
Last Update Date	:	06/22/2021

Similar Medicare Providers

1578543336 — DR. NEIL SHERNOFF M.D.
Practice Location Address:

4110 N 108TH AVE STE 105
PHOENIX, AZ
85037-5772

Practice Phone: 623-772-6999
Practice Fax: 623-772-6444

1043313646 — MRS. RUKIYA J CHAVERS FNP C
Practice Location Address:

4110 N 108TH AVE STE 105
PHOENIX, AZ
85037-5772

Practice Phone: 623-772-6999
Practice Fax: 623-772-6444

1821206343 — WEST VALLEY URGENT CARE
Practice Location Address:

4110 N 108TH AVE STE 101
PHOENIX, AZ
85037-5772

Practice Phone: 623-334-8670
Practice Fax:

1548431075 — COMPLETE PHYSICAL THERAPY INC
Practice Location Address:

4110 N 108TH AVE STE 103
PHOENIX, AZ
85037-5772

Practice Phone: 623-877-9915
Practice Fax:

1881077279 — DIGESTIVE HEALTH & WELLNESS, LLC
Practice Location Address:

4110 N 108TH AVE , STE. 105
PHOENIX, AZ
85037-5772

Practice Phone: 623-772-6999
Practice Fax: 623-772-6444

1538630280 — JESSICA L SEGURA GUERRERO FNP
Practice Location Address:

4110 N 108TH AVE STE 105
PHOENIX, AZ
85037-5772

Practice Phone: 699-962-3772
Practice Fax:

Directions to “ MRS. RAQUEL IVET RIVAS FNP-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.