Provider Demographics
NPI:1023887254
Name:FELDMAN, JESSICA DIANE (FNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:DIANE
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:DIANE
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10621 VISTA ALEGRE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3621
Mailing Address - Country:US
Mailing Address - Phone:915-706-3535
Mailing Address - Fax:
Practice Address - Street 1:5915 SILVER SPRINGS DR BLDG 3A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4126
Practice Address - Country:US
Practice Address - Phone:915-228-3080
Practice Address - Fax:915-226-0076
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1151057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily