Provider Demographics
NPI:1053394866
Name:ALVAREZ, BETTINA GISELLE (RN,BSN,MSN,FNP)
Entity type:Individual
Prefix:MS
First Name:BETTINA
Middle Name:GISELLE
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:RN,BSN,MSN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:MC DERMITT
Mailing Address - State:NV
Mailing Address - Zip Code:89421-0344
Mailing Address - Country:US
Mailing Address - Phone:775-532-4366
Mailing Address - Fax:775-532-4366
Practice Address - Street 1:120 CORDERO ROAD
Practice Address - Street 2:
Practice Address - City:MCDERMITT
Practice Address - State:NV
Practice Address - Zip Code:89421-0315
Practice Address - Country:US
Practice Address - Phone:775-532-4366
Practice Address - Fax:775-532-3664
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-25
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN89960363LF0000X
KS53-46038-022363LF0000X
NVAPRN002392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS53-46038-022OtherADVANCED PRACTICE NURSE
CA15342OtherNURSE PRACTITIONER