Provider Demographics
NPI:1679462642
Name:ALVARADO, SHEYANNE R (LPN)
Entity type:Individual
Prefix:
First Name:SHEYANNE
Middle Name:R
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SHEYANNE
Other - Middle Name:
Other - Last Name:MARES PERRIGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:5030 BAYPORT RD
Mailing Address - Street 2:
Mailing Address - City:MOUND
Mailing Address - State:MN
Mailing Address - Zip Code:55364-1749
Mailing Address - Country:US
Mailing Address - Phone:605-858-2765
Mailing Address - Fax:
Practice Address - Street 1:16768 TARRAGON CIRCLE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136
Practice Address - Country:US
Practice Address - Phone:308-380-9063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN762759164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse