MEDICARE: ANDREA R JIMENEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2278E1000X	Educational Certified Respiratory Therapist	2272	NM

General Provider Information

NPI Number	:	1255266144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA R JIMENEZ

Provider Business Mailing Address
First Line	:	7100 REDONDO ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-0812
Country	:	US
Telephone Number	:	575-650-5529
Fax Number	:

Provider Business Practice Location Address
First Line	:	7100 REDONDO ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-0812
Country	:	US
Telephone Number	:	575-650-5529
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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Directions to “ ANDREA R JIMENEZ ” Practice Location

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