Provider Demographics
NPI:1801781596
Name:ALVIDREZ, ROSA LINDA BANDA
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:LINDA BANDA
Last Name:ALVIDREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 AVENUE K
Mailing Address - Street 2:
Mailing Address - City:COZAD
Mailing Address - State:NE
Mailing Address - Zip Code:69130-1459
Mailing Address - Country:US
Mailing Address - Phone:308-325-8929
Mailing Address - Fax:
Practice Address - Street 1:1112 AVENUE G
Practice Address - Street 2:
Practice Address - City:GOTHENBURG
Practice Address - State:NE
Practice Address - Zip Code:69138-2035
Practice Address - Country:US
Practice Address - Phone:308-325-8929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion