Provider Demographics
NPI:1285845321
Name:JARAMILLO, MARIA CARMEN (FNP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CARMEN
Last Name:JARAMILLO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:CARMEN
Other - Last Name:JARAMILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:609 S NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6923
Mailing Address - Country:US
Mailing Address - Phone:956-463-7610
Mailing Address - Fax:956-609-8225
Practice Address - Street 1:801 E NOLANA STE 13-A
Practice Address - Street 2:N/A
Practice Address - City:MCALLEN, TEXAS 78504
Practice Address - State:TX
Practice Address - Zip Code:78504-6117
Practice Address - Country:US
Practice Address - Phone:956-686-2700
Practice Address - Fax:956-686-2708
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP112816363LF0000X, 363L00000X
TX626624363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1723421Medicaid
TXAP112816OtherMEDICAL LICENSE