Provider Demographics
NPI:1225779960
Name:NP-MAR LLC
Entity Type:Organization
Organization Name:NP-MAR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ALVARADO
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:817-938-0037
Mailing Address - Street 1:239 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-8354
Mailing Address - Country:US
Mailing Address - Phone:817-938-0037
Mailing Address - Fax:
Practice Address - Street 1:2131 ALPINE RD
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-3402
Practice Address - Country:US
Practice Address - Phone:903-757-8786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty