Provider Demographics
NPI:1962040360
Name:VELIZ, JESSICA (NP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:VELIZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 N OREGON ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3170
Mailing Address - Country:US
Mailing Address - Phone:915-317-1660
Mailing Address - Fax:915-320-4848
Practice Address - Street 1:2600 N OREGON ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3170
Practice Address - Country:US
Practice Address - Phone:915-317-1660
Practice Address - Fax:915-320-4848
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144218363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX832369OtherTEXAS NURSING BOARD RN
TXAP144218OtherTEXAS NURSING BOARD APRN