Provider Demographics
NPI:1336016096
Name:ALVARADO, JENNYFER BERIDIS
Entity type:Individual
Prefix:
First Name:JENNYFER
Middle Name:BERIDIS
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11110 MINES RD STE 104
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-7981
Mailing Address - Country:US
Mailing Address - Phone:956-625-2030
Mailing Address - Fax:
Practice Address - Street 1:11110 MINES RD STE 104
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-7981
Practice Address - Country:US
Practice Address - Phone:956-625-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-18
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX983278163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse