Provider Demographics
NPI:1558610477
Name:GUERRA, JESUS RENE (FNP)
Entity Type:Individual
Prefix:MR
First Name:JESUS
Middle Name:RENE
Last Name:GUERRA
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1259 CHLOE RAE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596
Mailing Address - Country:US
Mailing Address - Phone:956-447-8600
Mailing Address - Fax:
Practice Address - Street 1:906 S. BRIDGE AVE.
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596
Practice Address - Country:US
Practice Address - Phone:956-447-8600
Practice Address - Fax:956-447-0335
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX617448363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily