Provider Demographics
NPI:1083258248
Name:OLIVAREZ, JESSICA MARIE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:MARIE
Last Name:OLIVAREZ
Suffix:
Gender:F
Credentials:FNP-C
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Mailing Address - Street 1:18980 WEST MEMORIAL DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338
Mailing Address - Country:US
Mailing Address - Phone:832-644-8930
Mailing Address - Fax:855-227-3506
Practice Address - Street 1:18980 W. MEMORIAL DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:832-644-8930
Practice Address - Fax:855-227-3506
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP141105363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner