MEDICARE: MS. LYDIA ALVAREZ FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP 2038	AZ
2	363LF0000X	Family Nurse Practitioner	NP6044	CA
3	363LF0000X	Family Nurse Practitioner	CNP01397	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407833239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LYDIA ALVAREZ FNP

Provider Business Mailing Address
First Line	:	3750 CHEMAWA RD NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97305-1119
Country	:	US
Telephone Number	:	503-304-7600
Fax Number	:

Provider Business Practice Location Address
First Line	:	3750 CHEMAWA RD NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97305-1119
Country	:	US
Telephone Number	:	503-304-7600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	03/07/2017

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