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General NPI Number Information
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NPI Number | 1740421817
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Entity Type | Individual
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Provider Name | DIANE RUTH ALVIES FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 03/02/2010
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Provider Practice Location Address
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Address Line | 1338 PHAY AVE
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City | CANON CITY
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State | CO
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Zip | 81212-2302
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Country | US
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Telephone | 719-285-2800
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Fax | 719-285-2801
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Provider Business Mailing Address
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Address Line | 4112 OUTLOOK BLVD SUITE 37
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City | PUEBLO
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State | CO
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Zip | 81008-1667
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Country | US
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Telephone |
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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 | 14826
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License Number State | MD
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