Provider Demographics
NPI:1528550936
Name:ALVAREZ, IVETTE GISELL (PA-C)
Entity Type:Individual
Prefix:MS
First Name:IVETTE
Middle Name:GISELL
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 CONSTITUTION DR APT 805
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2891
Mailing Address - Country:US
Mailing Address - Phone:786-314-9811
Mailing Address - Fax:
Practice Address - Street 1:40 DUKE MEDICINE CIR # 2D
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-4000
Practice Address - Country:US
Practice Address - Phone:919-684-8845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-07697363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant