Provider Demographics
NPI:1700644192
Name:ALVAREZ, MARK JHERAN ZABAT (RN)
Entity Type:Individual
Prefix:
First Name:MARK JHERAN
Middle Name:ZABAT
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 34TH AVE S APT 312
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-5102
Mailing Address - Country:US
Mailing Address - Phone:701-793-8278
Mailing Address - Fax:
Practice Address - Street 1:3131 34TH AVE S APT 312
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-5102
Practice Address - Country:US
Practice Address - Phone:701-793-8278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR53318163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty