Healthcare Provider Details

I. General information

NPI: 1972491637
Provider Name (Legal Business Name): KATRINA ALVARADO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATRINA TOMPKINS

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W ROSS BLVD
DODGE CITY KS
67801-2131
US

IV. Provider business mailing address

PO BOX 426
BUCKLIN KS
67834-0426
US

V. Phone/Fax

Practice location:
  • Phone: 913-957-1247
  • Fax:
Mailing address:
  • Phone: 913-957-1247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number13-148369-12
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: