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NPI Code Detail

MEDICARE: NICOLE RIVERA

MEDICARE: NICOLE RIVERA
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1720937543
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE RIVERA
Provider Business Mailing Address
First Line : 749 9TH ST UNIT 208
Second Line :
City : DURHAM
State : NC
Zip : 27705-1060
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2301 ERWIN RD
Second Line :
City : DURHAM
State : NC
Zip : 27705-4699
Country : US
Telephone Number : 919-684-8111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2026
Last Update Date : 01/26/2026

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Directions to “ NICOLE RIVERA ” Practice Location

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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.

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