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General NPI Number Information
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NPI Number | 1679051189
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Entity Type | Individual
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Provider Name | JIMENA JOLLEY WHNP-BC, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/06/2018
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 27 MARROWS RD
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City | NEWARK
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State | DE
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Zip | 19713
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Country | US
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Telephone | 302-455-0900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 151
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City | NEW CASTLE
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State | DE
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Zip | 19720-0151
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Country | US
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Telephone | 302-652-2455
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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 | 163WW0101X
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Taxonomy Name | Ambulatory Women's Health Care Registered Nurse
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License Number | L1-0039216
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | L8-0010689
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | LH-0000230
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License Number State | DE
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