Healthcare Provider Details

I. General information

NPI: 1285429290
Provider Name (Legal Business Name): HEATHER LEA ALVAREZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 JEFFERSON ST NE STE A
ALBUQUERQUE NM
87113-1734
US

IV. Provider business mailing address

7227 LEE DEFOREST DR
COLUMBIA MD
21046-3236
US

V. Phone/Fax

Practice location:
  • Phone: 505-542-3131
  • Fax: 833-706-4363
Mailing address:
  • Phone: 443-860-5788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number14-114870-031
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: