Provider Demographics
NPI:1417571969
Name:NAVAR, VIVIANA S (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:VIVIANA
Middle Name:S
Last Name:NAVAR
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 JACK NICKLAUS DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3009
Mailing Address - Country:US
Mailing Address - Phone:915-820-1214
Mailing Address - Fax:
Practice Address - Street 1:1440 GEORGE DIETER DR # A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7601
Practice Address - Country:US
Practice Address - Phone:915-591-4444
Practice Address - Fax:915-921-9000
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145951363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health