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General NPI Number Information
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NPI Number | 1851679732
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Entity Type | Individual
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Provider Name | KIMBERLY M JIMENEZ RN, NP
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Gender | Female
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Dates
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Enumeration Date | 07/27/2011
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Last Update Date | 04/18/2016
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Provider Practice Location Address
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Address Line | 3225 UNIVERSITY BLVD S SUITE 104
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City | JACKSONVILLE
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State | FL
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Zip | 32216-2762
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Country | US
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Telephone | 904-399-1171
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Fax | 904-725-1622
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Provider Business Mailing Address
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Address Line | PO BOX 43667
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City | JACKSONVILLE
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State | FL
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Zip | 32203-3667
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Country | US
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Telephone | 904-224-5189
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Fax | 904-725-1622
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9269242
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License Number State | FL
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