MEDICARE: JUAH NIMENE APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1020139	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0100130	CO

General Provider Information

NPI Number	:	1346830114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAH NIMENE APRN

Provider Business Mailing Address
First Line	:	PO BOX 940604
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77094-7604
Country	:	US
Telephone Number	:	281-815-3153
Fax Number	:

Provider Business Practice Location Address
First Line	:	15015 WESTHEIMER PKWY STE 1-2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-1676
Country	:	US
Telephone Number	:	347-378-7974
Fax Number	:	888-375-3511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2021
Last Update Date	:	05/30/2025

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