Provider Demographics
NPI:1396423505
Name:ALFARO, VERONICA MARIE (RN)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:MARIE
Last Name:ALFARO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 BRACKEN TRL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-4419
Mailing Address - Country:US
Mailing Address - Phone:209-499-4776
Mailing Address - Fax:
Practice Address - Street 1:904 BRACKEN TRL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-4419
Practice Address - Country:US
Practice Address - Phone:209-499-4776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95167821163W00000X
MTNUR-RN-LIC-76714163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse