Healthcare Provider Details

I. General information

NPI: 1518874874
Provider Name (Legal Business Name): ERICKA ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 W 4TH ST
MISHAWAKA IN
46544-1948
US

IV. Provider business mailing address

24467 COUNTY ROAD 16
ELKHART IN
46516-5645
US

V. Phone/Fax

Practice location:
  • Phone: 888-580-1060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number71018558A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: