Most Relevant Information
Provider Data
| NPI Number: | 1003468158 |
| Provider Name: | LAURA LYNN RIVERA CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 4704272781 |
Most Important Dates
| Enumeration Date: | 07/09/2019 |
| Last Updated: | 07/09/2019 |
Provider Practice Location
2799 W GRAND BLVD
DETROIT
MI
482022608
Practice Location Phone/Fax
| Phone: | 3139162600 |
| Fax: |
Provider Mailing Location
2139 OAKNOLL ST
AUBURN HILLS
MI
483263126
Provider Mailing Phone/Fax
| Phone: | 2487018451 |
| Fax: |