Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 209011750 | IL |
NPI | 1003216052 |
---|---|
Provider Name | Norma Alvarado-Urrutia |
First Address | Sterling, IL 61081-3510 |
Second Address | Sterling, IL 61081-3510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2014 |
Last Update Date | 27/08/2014 |