Healthcare Provider Details

I. General information

NPI: 1932947496
Provider Name (Legal Business Name): JEIMMY ARTILES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEIMMY FRANCO

II. Dates (important events)

Enumeration Date: 07/18/2024
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 BROAD ROCK BLVD
RICHMOND VA
23249-0001
US

IV. Provider business mailing address

9413 LAUGHING OAK CT
HENRICO VA
23228-1553
US

V. Phone/Fax

Practice location:
  • Phone: 804-675-5000
  • Fax:
Mailing address:
  • Phone: 646-512-4406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number1031484
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number135459
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: