MEDICARE: MRS. CLAUDIA RENEE RIVARD LPN

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	164W00000X	Licensed Practical Nurse	010321-22	NH

General Provider Information

NPI Number	:	1205980612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CLAUDIA RENEE RIVARD LPN

Provider Business Mailing Address
First Line	:	58 STAGE RD
Second Line	:
City	:	DEERFIELD
State	:	NH
Zip	:	03037-1607
Country	:	US
Telephone Number	:	603-463-9018
Fax Number	:

Provider Business Practice Location Address
First Line	:	58 STAGE RD
Second Line	:
City	:	DEERFIELD
State	:	NH
Zip	:	03037-1607
Country	:	US
Telephone Number	:	603-463-9018
Fax Number	:

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	07/08/2007

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