| Doctor Name: | MR. LARRY ALONSO |
| NPI Number: | 1861414914 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-BC |
| License Number: | R54136 |
| Business Practice Address: | Acoma-acoma-laguna Hospital Exit 102 Off Hwy I-40 San Fidel, NM - 87049 |
| Business Phone Number: | 5058316300 |
| Business Fax Number: | |
| Mailing Address: | 10221 Green River Pl Nw, ALBUQUERQUE |
| State: | NM |
| Postal Code: | 871143966 |
| Phone Number: | 5059772967 |
| Fax Number: | |
| NPI Enumeration Date: | 07/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R54136 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |