Provider Demographics
NPI:1477166684
Name:ESPINO, JEANETTE (BSC,BSN-RN,MSN,FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JEANETTE
Middle Name:
Last Name:ESPINO
Suffix:
Gender:F
Credentials:BSC,BSN-RN,MSN,FNP-C
Other - Prefix:MRS
Other - First Name:JEANETTE
Other - Middle Name:
Other - Last Name:ESPINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSC,BSN-RN,MSN,FNP-C
Mailing Address - Street 1:1203 BUTLER DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4947
Mailing Address - Country:US
Mailing Address - Phone:210-789-7966
Mailing Address - Fax:
Practice Address - Street 1:9594 POTRANCO RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-9619
Practice Address - Country:US
Practice Address - Phone:210-963-7283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX908406163W00000X
TX1010943363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1010943Other1010943