Provider Demographics
NPI:1710165881
Name:ALCON-ROMERO, JESSICA LYNN (CNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:ALCON-ROMERO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PRESBYTERIAN HEALTHCARE SERVICES
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-6770
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:1010 SPRUCE ST
Practice Address - Street 2:PMG ESPANOLA
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-2724
Practice Address - Country:US
Practice Address - Phone:505-367-0365
Practice Address - Fax:505-367-0362
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2014-09-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMR62161163W00000X
NMCNP-02437363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse