MEDICARE: GINA GENETTE JASSO

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	363LF0000X	Family Nurse Practitioner	1212332	TX

General Provider Information

NPI Number	:	1871447490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA GENETTE JASSO

Provider Business Mailing Address
First Line	:	14732 TIERRA ISAIAH AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-2310
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8915 MONTANA AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79925-1202
Country	:	US
Telephone Number	:	915-225-0770
Fax Number	:

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

Provider Enumeration Date	:	02/21/2026
Last Update Date	:	02/21/2026

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Directions to “ GINA GENETTE JASSO ” Practice Location

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