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General NPI Number Information
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NPI Number | 1760084206
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Entity Type | Individual
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Provider Name | VANESSA JIMENEZ NP
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Gender | Female
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 02/15/2026
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Provider Practice Location Address
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Address Line | 2336 WISTERIA DR STE 110
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City | SNELLVILLE
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State | GA
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Zip | 30078-6162
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Country | US
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Telephone | 470-481-7803
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Fax | 833-941-5113
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Provider Business Mailing Address
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Address Line | 850 DOGWOOD RD STE B200 #2064
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-7213
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Country | US
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Telephone | 470-342-8578
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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 | RN236784
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License Number State | GA
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