Provider Demographics
NPI:1154839223
Name:RIVERS, LYNDA (ARNP212206)
Entity type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:RIVERS
Suffix:
Gender:F
Credentials:ARNP212206
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 OKEECHOBEE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2099
Mailing Address - Country:US
Mailing Address - Phone:561-964-1111
Mailing Address - Fax:
Practice Address - Street 1:8200 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2099
Practice Address - Country:US
Practice Address - Phone:561-964-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-11
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9212206363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care