MEDICARE: MS. NORMA JACQUEZ RN, APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	1032878	TX

General Provider Information

NPI Number	:	1013593029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NORMA JACQUEZ RN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	11113 EBB TIDE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-2928
Country	:	US
Telephone Number	:	915-490-8808
Fax Number	:

Provider Business Practice Location Address
First Line	:	1671 N ZARAGOZA RD STE B
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-8058
Country	:	US
Telephone Number	:	915-996-5210
Fax Number	:	915-996-5211

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2021
Last Update Date	:	09/16/2025

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