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General NPI Number Information
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NPI Number | 1821607219
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Entity Type | Individual
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Provider Name | ALENA VLADIMIROVNA CUNDIFF
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Gender | Female
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Dates
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Enumeration Date | 07/30/2020
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Last Update Date | 07/02/2024
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Provider Practice Location Address
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Address Line | 7321 SOUTHERN BELLE CIR
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City | ABILENE
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State | TX
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Zip | 79602-1550
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Country | US
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Telephone | 432-222-7177
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Fax |
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Provider Business Mailing Address
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Address Line | 1210 CEDAR CREEK RD
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City | MIDLAND
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State | TX
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Zip | 79705-4471
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Country | US
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Telephone | 432-254-1757
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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 | 1007049
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License Number State | TX
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