Provider Demographics
NPI:1619837838
Name:RIVERA LOPEZ, SARAH (ACNPC-AG)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:RIVERA LOPEZ
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5568 MARBLEHEAD DR
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:NC
Mailing Address - Zip Code:27235-9827
Mailing Address - Country:US
Mailing Address - Phone:336-448-8237
Mailing Address - Fax:
Practice Address - Street 1:5568 MARBLEHEAD DR
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:NC
Practice Address - Zip Code:27235-9827
Practice Address - Country:US
Practice Address - Phone:336-448-8237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000639352363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner