Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 1032878 | TX |
NPI | 1013593029 |
---|---|
Provider Name | Ms. Norma Jacquez |
First Address | El Paso, TX 79936-2928 |
Second Address | El Paso, TX 79936-8058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2021 |
Last Update Date | 20/03/2021 |