Individual
JESSICA VICTORIA CARBAJAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
14557 ACHIM DR, EL PASO, TX 79928-7367
(915) 861-6565
Mailing address
14557 ACHIM DR, EL PASO, TX 79928-7367
(915) 861-6565
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
231661
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
231661
TBON
TX
Enumeration date
07/24/2019
Last updated
07/24/2019
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