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General NPI Number Information
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NPI Number | 1649912320
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Entity Type | Individual
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Provider Name | DEISY ALI JAIMES-JAIMES DNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 2909 N IH 35
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City | AUSTIN
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State | TX
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Zip | 78722-2304
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Country | US
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Telephone | 512-478-2939
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Fax |
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Provider Business Mailing Address
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Address Line | 11025 DOYLE OVERTON RD UNIT 23
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City | DEL VALLE
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State | TX
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Zip | 78617-5349
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Country | US
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Telephone | 512-299-5565
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1071150
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License Number State | TX
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