Provider Demographics
NPI:1245946342
Name:NUNEZ, JESSICA GUTIERREZ
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:GUTIERREZ
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3965 BRECKENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-1205
Mailing Address - Country:US
Mailing Address - Phone:915-282-4275
Mailing Address - Fax:
Practice Address - Street 1:3965 BRECKENRIDGE DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-1205
Practice Address - Country:US
Practice Address - Phone:915-282-4275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist