Provider Demographics
NPI:1053010587
Name:PALAFOX, JO ANN
Entity type:Individual
Prefix:
First Name:JO
Middle Name:ANN
Last Name:PALAFOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 SAN CLEMENTE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-6431
Mailing Address - Country:US
Mailing Address - Phone:915-276-4422
Mailing Address - Fax:
Practice Address - Street 1:6006 N MESA ST STE 902
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4655
Practice Address - Country:US
Practice Address - Phone:915-276-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601760163WG0000X
TX1112698363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice