Healthcare Provider Details

I. General information

NPI: 1437428729
Provider Name (Legal Business Name): JENNIFER ALEXA FIMBRES NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ALEXA SHULICK NP-C

II. Dates (important events)

Enumeration Date: 12/15/2011
Last Update Date: 10/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3611 N CAMPBELL AVE
TUCSON AZ
85719-1534
US

IV. Provider business mailing address

10633 E SINGING CANYON DR
TUCSON AZ
85747-6010
US

V. Phone/Fax

Practice location:
  • Phone: 520-881-0636
  • Fax: 520-881-0637
Mailing address:
  • Phone: 520-704-5538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP4298
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: