Provider Demographics
NPI:1740011451
Name:OLIVAREZ, REBECCA DANIELLE (APRN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:DANIELLE
Last Name:OLIVAREZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E SAVANNAH AVE STE 18
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1728
Mailing Address - Country:US
Mailing Address - Phone:956-238-2853
Mailing Address - Fax:480-900-8559
Practice Address - Street 1:1200 E SAVANNAH AVE STE 18
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1728
Practice Address - Country:US
Practice Address - Phone:956-238-2853
Practice Address - Fax:480-900-8559
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1170907363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner