Provider Demographics
NPI:1104656859
Name:AREVALO, GUADALUPE (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:
Last Name:AREVALO
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1506
Mailing Address - Country:US
Mailing Address - Phone:956-630-5522
Mailing Address - Fax:
Practice Address - Street 1:500 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1506
Practice Address - Country:US
Practice Address - Phone:956-630-5522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1170773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty