Rivera, Kenneth
Rivera, Kenneth is an individual health care provider with primary practice located at 104 W D. L. Ingram Ave , Cannon Afb NM 88101. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Rivera, Kenneth can be contacted via phone (575) 784-2778.Contact Information
Primary practice address
104 W D. L. Ingram Ave
Cannon Afb NM 88101
Phone: (575) 784-2778
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X |
Profile Details
| NPI number | 1780399501 |
|---|---|
| LBN Legal business name | Rivera, Kenneth |
| Credentials | PHYSICIAN ASSISTANT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 16th, 2023 |
| Last updated | Mar 8th, 2024 - about last year |
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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