Rivera, Erin Eileen

Rivera, Erin Eileen is an individual health care provider with primary practice located at 415 E Cook Rd Suite 100, Fort Wayne IN 46825-3636. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist. Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist is her primary health care specialty. Rivera, Erin Eileen can be contacted via phone (260) 489-6030.

Contact Information

Primary practice address
415 E Cook Rd Suite 100 Fort Wayne IN 46825-3636
Phone: (260) 489-6030
Fax: (260) 489-5536
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 364SG0600X 70000103A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist 364S00000X 70000103A Indiana

Profile Details

NPI number 1790893147
LBN Legal business name Rivera, Erin Eileen
Credentials PHD, CNS, APRN, BC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2006
Last updated Apr 4th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790893147 NPPES
Indiana MEDICAID 201006300

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