Provider Demographics
NPI:1801568647
Name:JAIME, JESSE JAMES (FNP-BC)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:JAMES
Last Name:JAIME
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7249 BLACK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7258
Mailing Address - Country:US
Mailing Address - Phone:915-740-7615
Mailing Address - Fax:
Practice Address - Street 1:1810 MURCHISON DRIVE
Practice Address - Street 2:STE 104
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2906
Practice Address - Country:US
Practice Address - Phone:281-888-8999
Practice Address - Fax:281-305-4054
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM68411363LF0000X
TX1043918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily