MEDICARE: DIANE LYNN ALVAREZ FNP-C

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	0024175726	VA

General Provider Information

NPI Number	:	1588165591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE LYNN ALVAREZ FNP-C

Provider Business Mailing Address
First Line	:	2543 WALDO LN
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-5146
Country	:	US
Telephone Number	:	804-926-8466
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 GLEN FOREST DR STE 106
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-3768
Country	:	US
Telephone Number	:	804-495-0053
Fax Number	:

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

Provider Enumeration Date	:	02/24/2018
Last Update Date	:	08/27/2021

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