Provider Demographics
NPI:1154219483
Name:RIVERO, PATRICIA S (FNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:RIVERO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:PATTY
Other - Middle Name:S
Other - Last Name:RIVERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:144 VALHI LAGOON XING
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-3208
Mailing Address - Country:US
Mailing Address - Phone:985-223-0032
Mailing Address - Fax:
Practice Address - Street 1:5045 BRIDGEPORT WAY
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-3211
Practice Address - Country:US
Practice Address - Phone:985-860-2936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP203627363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily