Provider Demographics
NPI:1952192692
Name:ALVAREZ, NETTIE ANN
Entity type:Individual
Prefix:
First Name:NETTIE
Middle Name:ANN
Last Name:ALVAREZ
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 1:434 HAISLIP LN
Mailing Address - Street 2:
Mailing Address - City:AXTON
Mailing Address - State:VA
Mailing Address - Zip Code:24054-3716
Mailing Address - Country:US
Mailing Address - Phone:276-734-0197
Mailing Address - Fax:
Practice Address - Street 1:434 HAISLIP LN
Practice Address - Street 2:
Practice Address - City:AXTON
Practice Address - State:VA
Practice Address - Zip Code:24054-3716
Practice Address - Country:US
Practice Address - Phone:276-734-0197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001253732163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice