Healthcare Provider Details

I. General information

NPI: 1275297533
Provider Name (Legal Business Name): ZAINAB OYENIKE JIMADA DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2021
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 FOSTER ST
PEABODY MA
01960-8925
US

IV. Provider business mailing address

27 CONGRESS ST STE 513
SALEM MA
01970-5523
US

V. Phone/Fax

Practice location:
  • Phone: 978-532-4903
  • Fax:
Mailing address:
  • Phone: 978-744-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number779543
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number350617
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2377702
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: