Healthcare Provider Details

I. General information

NPI: 1033846738
Provider Name (Legal Business Name): JESSICA A BARRERA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 N GRIMES ST
HOBBS NM
88240-1219
US

IV. Provider business mailing address

4008 FIESTA DR
HOBBS NM
88240-0980
US

V. Phone/Fax

Practice location:
  • Phone: 575-393-9202
  • Fax:
Mailing address:
  • Phone: 575-441-7581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number68942
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: