Mary Jacqueline FNP-C-PC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

MARY JACQUELINE FNP-C-PC

Practice address

2281 W 24TH St Ste 15
Yuma, AZ 85364-6197

Phone

(928) 726-6772

Fax

(928) 726-3012

NPI assigned

May 14, 2025

Last updated

May 14, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

-As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yvette Paradeza

Title

Office Manager

Phone

(928) 726-6772

Specialties & licenses 1

Addresses

Other names 2

• Mary Jacqueline FNP-C-PC Former legal business name
• Mary Jacqueline-FNP-C-PC Former legal business name

Part of

Mary Jacqueline FNP-C-PC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• -

  dba Premierwound.care

  • General Practice Physician
  • Gilbert, AZ
  • NPI 1518779461
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1588455968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2281 W 24TH ST STE 15",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646197",
            "telephone_number": "928-726-6772",
            "fax_number": "928-726-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2281 W 24TH ST STE 15",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646197",
            "telephone_number": "928-726-6772",
            "fax_number": "928-726-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY JACQUELINE FNP-C-PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "-",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "PARADEZA",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-726-6772"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Jacqueline FNP-C-PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Mary Jacqueline-FNP-C-PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Juan C Martinez, RBT
• Karina Martinez
• Patricia Ann Martinez, LPC
• Renata Martinez, BHT, B.A.SOC, B.A.PS
• Ryan Martz
• Ellen Leroy Mary
• Collet R Masillamoni, D.D.S.
• Eswar Reddy Masireddy, BPHARM
• Nathan M Mason, ARNP
• Elena Silva Massart, SLPA

• Primary Care Nurse Practitioner in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.