MEDICARE: JEANNE M 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	CNP-01421	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50008796	OTHER	ME	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	048305	OTHER	ME	ANTHEM STAR NUMBER

General Provider Information

NPI Number	:	1871599233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNE M ALVAREZ FNP

Provider Business Mailing Address
First Line	:	#28 ON HIGHWAY 571
Second Line	:
City	:	EL RITO
State	:	NM
Zip	:	87530-0237
Country	:	US
Telephone Number	:	575-581-4728
Fax Number	:	575-581-0030

Provider Business Practice Location Address
First Line	:	STATE RD 571 BLDG #28
Second Line	:
City	:	EL RITO
State	:	NM
Zip	:	87530-0237
Country	:	US
Telephone Number	:	575-581-4728
Fax Number	:	575-581-4731

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	03/23/2023

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Directions to “ JEANNE M ALVAREZ FNP” Practice Location

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