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General NPI Number Information
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NPI Number | 1780519033
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Entity Type | Individual
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Provider Name | BRIANNE MARIA JIMENEZ
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Gender | Female
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Dates
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Enumeration Date | 06/17/2026
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Last Update Date | 06/17/2026
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Provider Practice Location Address
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Address Line | 43 WOODLAND ST # 49
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City | HARTFORD
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State | CT
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Zip | 06105-2363
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Country | US
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Telephone | 888-793-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 690 BROAD ST APT 3N
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City | MERIDEN
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State | CT
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Zip | 06450-4370
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Country | US
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Telephone | 929-580-8729
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 7844
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License Number State | CT
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