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General NPI Number Information
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NPI Number | 1871726703
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Entity Type | Individual
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Provider Name | EDGAR JIMENEZ FNP
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Gender | Male
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 10/05/2025
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Provider Practice Location Address
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Address Line | UNIT 2060
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City | APO
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State | AP
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Zip | 96278-2060
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Country | US
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Telephone | 310-784-5603
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 3 BOX 10411R
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City | APO
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State | AP
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Zip | 96266-0105
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Country | US
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Telephone | 310-784-5603
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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 | 627728
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License Number State | TX
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