| Doctor Name: | LYDIA H. RIVERA |
| NPI Number: | 1225479868 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | TAP5061 |
| Business Practice Address: | 1209 W Target Range Rd Nogales, AZ - 856212466 |
| Business Phone Number: | 5202874747 |
| Business Fax Number: | 5202853136 |
| Mailing Address: | 2202 N Forbes Blvd, TUCSON |
| State: | AZ |
| Postal Code: | 857451412 |
| Phone Number: | 5208727536 |
| Fax Number: | 5208727929 |
| NPI Enumeration Date: | 07/11/2013 |
| NPI Last Update Date: | 07/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SF0001X |
| License Number: | TAP5061 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Family Health |
| Taxonomy Definition: | |