Individual
JACLYN MICHELLE FIKE-TAVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
6004 BALCONES CT, EL PASO, TX 79912-3319
(662) 202-6485
Mailing address
6004 BALCONES CT, EL PASO, TX 79912-3319
(662) 202-6485
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1140696
TX
363LA2200X
Adult Health Nurse Practitioner
1140696
TX
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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