Provider Demographics
NPI:1538779368
Name:MARTINEZ, JESSICA KRISTEN (APRN)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:KRISTEN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:1515 PAPPAS ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-1705
Mailing Address - Country:US
Mailing Address - Phone:956-795-8100
Mailing Address - Fax:855-698-3232
Practice Address - Street 1:1515 PAPPAS ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-1705
Practice Address - Country:US
Practice Address - Phone:956-795-8100
Practice Address - Fax:855-698-3232
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP144575363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily