Provider Demographics
NPI:1033846738
Name:BARRERA, JESSICA A (CNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:BARRERA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 FIESTA DR
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-0980
Mailing Address - Country:US
Mailing Address - Phone:575-441-7581
Mailing Address - Fax:
Practice Address - Street 1:3305 N GRIMES ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-1219
Practice Address - Country:US
Practice Address - Phone:575-393-9202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM68942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily