Provider Demographics
NPI:1588980841
Name:RIVERA, RACHEAL ANN (RN)
Entity type:Individual
Prefix:MS
First Name:RACHEAL
Middle Name:ANN
Last Name:RIVERA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7625 S 24TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-7009
Mailing Address - Country:US
Mailing Address - Phone:858-248-7988
Mailing Address - Fax:480-967-8023
Practice Address - Street 1:7625 S 24TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-7009
Practice Address - Country:US
Practice Address - Phone:480-966-1902
Practice Address - Fax:480-967-8023
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA759913163W00000X, 163WM0102X, 163WN0003X, 163WX0002X, 163WX0003X
AZ267805163WM0102X, 163WN0003X, 163WX0002X, 163WX0003X, 367A00000X
TX788865163WX0002X
CA222445164X00000X
CA236296367A00000X, 363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No164X00000XNursing Service ProvidersLicensed Vocational Nurse
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health