Provider Demographics
NPI:1720814163
Name:MEDINA, GUIA JESSICA (FNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:GUIA JESSICA
Middle Name:
Last Name:MEDINA
Suffix:
Gender:F
Credentials:FNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7210 N 56TH ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-8807
Mailing Address - Country:US
Mailing Address - Phone:956-533-2409
Mailing Address - Fax:
Practice Address - Street 1:110 E SAVANNAH AVE STE 201
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1241
Practice Address - Country:US
Practice Address - Phone:956-800-1820
Practice Address - Fax:956-552-6882
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1164865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily