Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 4704240283 | MI |
NPI | 1003215260 |
---|---|
Provider Name | Julie Ann Alvarado |
First Address | Lansing, MI 48911-4299 |
Second Address | Williamston, MI 48895-1623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2014 |
Last Update Date | 17/04/2018 |