Individual
JESSICA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS
Contact information
Practice address
801 W MAPLE ST, FARMINGTON, NM 87401-5630
(505) 609-2000
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2022-0037
NM
Other
Enumeration date
11/14/2021
Last updated
11/12/2024
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