Individual provider · Type 1 NPI
Lacey Mae Rivera
Family Nurse Practitioner · South Jordan, UT
NPI number
1790607497
Active
Practice location
473 W Aspen Peak Dr
South Jordan, UT 84095-4129
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 13002591-4405 (UT) |
Family Nurse Practitioner: Definition to come...
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About NPI 1790607497
Lacey Mae Rivera's National Provider Identifier is 1790607497, issued on Jul 27, 2026. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in South Jordan, UT. The record was last updated on Jul 27, 2026.