MEDICARE: JESSICA RENEE YANEZ

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	163W00000X	Registered Nurse	935012	TX

General Provider Information

NPI Number	:	1740127513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA RENEE YANEZ

Provider Business Mailing Address
First Line	:	768 NOGALES AVE
Second Line	:
City	:	CHAPARRAL
State	:	NM
Zip	:	88081-7624
Country	:	US
Telephone Number	:	915-519-0088
Fax Number	:

Provider Business Practice Location Address
First Line	:	299 SHADOW MOUNTAIN DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4748
Country	:	US
Telephone Number	:	915-519-0088
Fax Number	:

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

Provider Enumeration Date	:	04/30/2026
Last Update Date	:	04/30/2026

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