=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457159378
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JESSICA YVETTE OROZCO FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2025
-----------------------------------------------------
Last Update Date | 03/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 494 N KENAZO AVE
-----------------------------------------------------
City | HORIZON CITY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79928-5419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-845-7300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14525 LONG SHADOW AVE
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79938-4526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-873-5377
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1180722
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------