Provider Demographics
NPI:1417346693
Name:ALCANTAR, LAURA (FNP-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ALCANTAR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11988 PASEO DEL REY DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-3787
Mailing Address - Country:US
Mailing Address - Phone:915-201-7384
Mailing Address - Fax:
Practice Address - Street 1:600 SUNLAND PARK DR STE 1-400
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5135
Practice Address - Country:US
Practice Address - Phone:915-201-7384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX721766OtherRN LIC.
TXAP127236OtherAPRN LIC.