Provider Demographics
NPI:1730404989
Name:ALVAREZ, NICOLE JEANNE (CRNA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:JEANNE
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:JEANNE
Other - Last Name:DUPREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:39010 MACARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-2468
Mailing Address - Country:US
Mailing Address - Phone:405-585-2005
Mailing Address - Fax:
Practice Address - Street 1:39010 MACARTHUR ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-2468
Practice Address - Country:US
Practice Address - Phone:405-585-2005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK97895367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered