Basic Information
Provider Information
NPI: 1447840475
EntityType: 2
ReplacementNPI:  
OrganizationName: ALVAREZ ANESTHESIA, APRN-CRNA, PLLC
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Mailing Information
Address1: 415 W GRAY ST
Address2:  
City: NORMAN
State: OK
PostalCode: 730697117
CountryCode: US
TelephoneNumber: 4053297300
FaxNumber:  
Practice Location
Address1: 100 SE 59TH ST
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731293616
CountryCode: US
TelephoneNumber: 4056349300
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/23/2021
LastUpdateDate: 01/23/2021
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AuthorizedOfficialLastName: ALVAREZ
AuthorizedOfficialFirstName: NICOLE
AuthorizedOfficialMiddleName: JEANNE
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 4058126025
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: CRNA
NPICertificationDate: 01/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X  Y193400000X SINGLE SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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