Provider Demographics
NPI:1780303156
Name:ALFARO, EMMA ROSE (LVN)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:ROSE
Last Name:ALFARO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:ROSE
Other - Last Name:STALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:12014 BOBBI WAY UNIT 4
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-4250
Mailing Address - Country:US
Mailing Address - Phone:512-595-4290
Mailing Address - Fax:
Practice Address - Street 1:6600 E BEN WHITE BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-7537
Practice Address - Country:US
Practice Address - Phone:512-804-3770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX348130164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse