Provider Demographics
NPI:1134816523
Name:ARMENDARIZ, JESSICA JUNE (FNP-BC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:JUNE
Last Name:ARMENDARIZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4260 NORTHRISE DR APT 1912
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-7318
Mailing Address - Country:US
Mailing Address - Phone:575-626-1484
Mailing Address - Fax:
Practice Address - Street 1:4260 NORTHRISE DR APT 1912
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-7318
Practice Address - Country:US
Practice Address - Phone:575-626-1484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM72073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily