Provider Demographics
NPI:1285925826
Name:RIVERA, BRENDA JOSEPHINE (NP)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:JOSEPHINE
Last Name:RIVERA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1181 FIRST COLONIAL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2437
Mailing Address - Country:US
Mailing Address - Phone:757-425-1600
Mailing Address - Fax:
Practice Address - Street 1:1181 FIRST COLONIAL RD STE 200
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2437
Practice Address - Country:US
Practice Address - Phone:757-425-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-01
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169364207V00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology