Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 266500 | MA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 266500 | MA |
NPI | 1760745202 |
---|---|
Provider Name | Dr. Kristin Mckenzie Alves |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27610-1214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2012 |
Last Update Date | 02/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1760745202 | (05) | NC |