Provider Demographics
NPI:1215236831
Name:ALVAREZ, KELLY ANN (ACNP-BC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7812 GATEWAY BLVD E STE 200
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-1836
Mailing Address - Country:US
Mailing Address - Phone:915-592-6868
Mailing Address - Fax:915-592-6889
Practice Address - Street 1:7812 GATEWAY BLVD E STE 200
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1836
Practice Address - Country:US
Practice Address - Phone:915-592-6868
Practice Address - Fax:915-592-6889
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX731840363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care