Provider Demographics
NPI:1558083402
Name:ALAMO, RENE ROBERT (PMHNP)
Entity type:Individual
Prefix:MR
First Name:RENE
Middle Name:ROBERT
Last Name:ALAMO
Suffix:
Gender:M
Credentials:PMHNP
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Other - Credentials:
Mailing Address - Street 1:11048 W VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-6755
Mailing Address - Country:US
Mailing Address - Phone:208-546-9264
Mailing Address - Fax:208-203-7006
Practice Address - Street 1:11048 W VICTORIA DR
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-6755
Practice Address - Country:US
Practice Address - Phone:208-546-9264
Practice Address - Fax:208-203-7006
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-16
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ID78341363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health