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General NPI Number Information
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NPI Number | 1588219083
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Entity Type | Individual
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Provider Name | JOHANNA M ALVAREZ MSN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/02/2019
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 66 OLD AIRPORT RD
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City | HATTIESBURG
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State | MS
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Zip | 39401-8382
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Country | US
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Telephone | 601-544-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 22 JUBILEE PT
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City | HATTIESBURG
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State | MS
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Zip | 39402-7619
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Country | US
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Telephone | 254-577-9850
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 905927
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License Number State | MS
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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 | SP020416
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License Number State | PA
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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 | 171476
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License Number State | AK
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