Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 1061391 | TX |
NPI | 1093332702 |
---|---|
Provider Name | Armando Alvarez |
First Address | Kenner, LA 70065-2467 |
Second Address | Kenner, LA 70065-5536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2020 |
Last Update Date | 31/01/2022 |