Provider Demographics
NPI:1467112847
Name:MARTINEZ, JESSICA TREVINO (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:TREVINO
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1012 EAST DOVE AVENUE
Mailing Address - Street 2:UNIT 23
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504
Mailing Address - Country:US
Mailing Address - Phone:210-288-9782
Mailing Address - Fax:
Practice Address - Street 1:5323 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9115
Practice Address - Country:US
Practice Address - Phone:956-362-2367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143816363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty