Provider Demographics
NPI:1194151217
Name:ESPINOSA, IVONNE (FNP)
Entity type:Individual
Prefix:MS
First Name:IVONNE
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6090 SURETY DR STE 400
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2060
Mailing Address - Country:US
Mailing Address - Phone:915-979-7402
Mailing Address - Fax:915-300-1947
Practice Address - Street 1:6090 SURETY DR STE 400
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2060
Practice Address - Country:US
Practice Address - Phone:915-979-7402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX749317363LF0000X, 363LP0808X
TXAP124716363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1831267079OtherGROUP NPI
TX130880104OtherGROUP TPI