MEDICARE: MS. AMANDA LEA 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
1	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse	RN341922	OH

General Provider Information

NPI Number	:	1982559829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMANDA LEA RIVERA

Provider Business Mailing Address
First Line	:	3 WALNUT TRL
Second Line	:
City	:	OLMSTED TWP
State	:	OH
Zip	:	44138-3053
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20611 EUCLID AVE
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44117-1521
Country	:	US
Telephone Number	:	855-967-2436
Fax Number	:

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

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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