Healthcare Provider Details

I. General information

NPI: 1295227502
Provider Name (Legal Business Name): ARTURO ALVARADO AGPCNP-BC, ACCNS-AG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2018
Last Update Date: 06/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 JOHN PAUL JONES CIR
PORTSMOUTH VA
23708-2111
US

IV. Provider business mailing address

350 SAWYERS MILL XING
CHESAPEAKE VA
23323-6397
US

V. Phone/Fax

Practice location:
  • Phone: 757-953-3420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number4209
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95001367
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: