Healthcare Provider Details

I. General information

NPI: 1245831122
Provider Name (Legal Business Name): KRISTI ALVERSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 INDUSTRIAL AVE
AZLE TX
76020-2901
US

IV. Provider business mailing address

201 S OAKRIDGE DR
HUDSON OAKS TX
76087-1793
US

V. Phone/Fax

Practice location:
  • Phone: 817-270-3132
  • Fax:
Mailing address:
  • Phone: 817-599-5518
  • Fax: 817-599-5538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1014614
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: