MEDICARE: LYANA RIVERO

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	163WH0200X	Home Health Registered Nurse	900407	NV
2	163W00000X	Registered Nurse	900407	NV

General Provider Information

NPI Number	:	1558297671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYANA RIVERO

Provider Business Mailing Address
First Line	:	2214 METALWOOD CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89142-1614
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2214 METALWOOD CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89142-1614
Country	:	US
Telephone Number	:	702-758-6172
Fax Number	:

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

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/18/2026

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