Provider Demographics
NPI:1871944975
Name:ALVAREZ, MARCIA (RN, MSN, PMHCNS-BC)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:RN, MSN, PMHCNS-BC
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1365 WESTGATE CENTER DR.
Mailing Address - Street 2:SUITE L-1
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2980
Mailing Address - Country:US
Mailing Address - Phone:336-659-7878
Mailing Address - Fax:336-659-7828
Practice Address - Street 1:1365 WESTGATE CENTER DR
Practice Address - Street 2:SUITE L-1
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2980
Practice Address - Country:US
Practice Address - Phone:336-659-7878
Practice Address - Fax:336-659-7828
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC198771364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health