Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenneth Rivera, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1780399501

Kenneth Rivera, PHYSICIANASSISTANT is a Physician Assistant in Cannon AFB, New Mexico. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

104 W D L Ingram Ave
Cannon AFB, NM 88101
Phone: (575) 784-2778
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1780399501
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedJanuary 16, 2023
Last updated in NPPESMarch 8, 2024
Certification dateMarch 8, 2024
Mailing address104 W D. L. Ingram Ave, Cannon Afb, NM 88101

Other providers in Cannon AFB