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General NPI Number Information
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NPI Number | 1447616313
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Entity Type | Individual
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Provider Name | JUANITA DAISY ALVAREZ-HALL MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/07/2016
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Last Update Date | 06/19/2016
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Provider Practice Location Address
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Address Line | 800 MERCY DR
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-3128
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Country | US
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Telephone | 712-328-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 800 MERCY DR
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-3128
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Country | US
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Telephone | 712-328-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 74124
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 111972
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A142915
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License Number State | IA
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