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General NPI Number Information
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NPI Number | 1891981676
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Entity Type | Individual
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Provider Name | RACHEL MICHELLE JIMENEZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 629 S PLUMMER AVE
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City | CHANUTE
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State | KS
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Zip | 66720-1928
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Country | US
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Telephone | 620-431-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 10806 W HAVENHURST ST
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City | MAIZE
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State | KS
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Zip | 67101-3710
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Country | US
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Telephone | 316-640-6105
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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 | 15-01179
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License Number State | KS
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