Provider Demographics
NPI:1104426642
Name:OLIVAS, ALEXANDRA (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:OLIVAS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 MURCHISON DR STE 104
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3058
Mailing Address - Country:US
Mailing Address - Phone:915-577-0051
Mailing Address - Fax:
Practice Address - Street 1:4532 N MESA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-6286
Practice Address - Country:US
Practice Address - Phone:915-544-0326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145376363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily