Provider Demographics
NPI:1699453621
Name:RIVERA, FELICIA (RN, APN)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:RN, APN
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:
Other - Last Name:CLOUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1102 LORETTA AVE
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-1411
Mailing Address - Country:US
Mailing Address - Phone:609-415-4187
Mailing Address - Fax:
Practice Address - Street 1:1102 LORETTA AVE
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-1411
Practice Address - Country:US
Practice Address - Phone:609-415-4187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14873200364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist