Individual
JESSICA CANALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4845 ALAMEDA AVE, EL PASO, TX 79905-2705
(915) 298-5444
Mailing address
3230 DESTINY POINT DR, EL PASO, TX 79938-5393
(915) 253-2916
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
772023
TX
363L00000X
Nurse Practitioner
Primary
AP132668
TX
363LP0200X
Pediatric Nurse Practitioner
AP132668
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
TX
Enumeration date
11/30/2016
Last updated
08/21/2023
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