Provider Demographics
NPI:1164075545
Name:ALVAREZ, JONATHAN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 W CADBURY CT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-5556
Mailing Address - Country:US
Mailing Address - Phone:520-551-3672
Mailing Address - Fax:
Practice Address - Street 1:4455 S I 19 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-5884
Practice Address - Country:US
Practice Address - Phone:520-393-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-24
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ225509208M00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist