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General NPI Number Information
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NPI Number | 1336921212
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Entity Type | Individual
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Provider Name | MAXXINE KRAEMER-JIMENEZ
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Gender | Female
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Dates
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Enumeration Date | 10/16/2023
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 74 BRICK BLVD STE 204
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City | BRICK
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State | NJ
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Zip | 08723-7984
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Country | US
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Telephone | 732-832-3444
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Fax | 732-832-3434
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Provider Business Mailing Address
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Address Line | 169 PRINCETON AVE
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City | BRICK
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State | NJ
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Zip | 08724-4329
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Country | US
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Telephone | 732-964-5499
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ14937200
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License Number State | NJ
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