Provider Demographics
NPI:1134949217
Name:ALVAREZ, SALOME (RN IBCLC)
Entity type:Individual
Prefix:
First Name:SALOME
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N WASHINGTON ST UNIT 16
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-5527
Mailing Address - Country:US
Mailing Address - Phone:602-459-2778
Mailing Address - Fax:
Practice Address - Street 1:123 N WASHINGTON ST UNIT 16
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-5527
Practice Address - Country:US
Practice Address - Phone:602-459-2778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN188078163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant