MEDICARE: IRENE EMANA ALFORD MSN APRN FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1032236	TX

General Provider Information

NPI Number	:	1194489104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRENE EMANA ALFORD MSN APRN FNP-C

Provider Business Mailing Address
First Line	:	15301 SPECTRUM DR STE 330
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-6462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2620 N TRAVIS ST # 400
Second Line	:
City	:	SHERMAN
State	:	TX
Zip	:	75092-2523
Country	:	US
Telephone Number	:	972-661-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2021
Last Update Date	:	08/19/2022

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