Provider Demographics
NPI:1679258321
Name:JUAREZ, ALICIA (APRN-CNP)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75652-3133
Mailing Address - Country:US
Mailing Address - Phone:903-392-8259
Mailing Address - Fax:903-657-1674
Practice Address - Street 1:105 N HIGH ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TX
Practice Address - Zip Code:75652-3133
Practice Address - Country:US
Practice Address - Phone:903-392-8259
Practice Address - Fax:903-657-1674
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1126562363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner