MEDICARE: QUINN JIMERSON

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	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1770429946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUINN JIMERSON

Provider Business Mailing Address
First Line	:	4805 N 72ND ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-2304
Country	:	US
Telephone Number	:	402-571-5400
Fax Number	:

Provider Business Practice Location Address
First Line	:	6240 N 51ST AVENUE CIR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-1329
Country	:	US
Telephone Number	:	402-812-7249
Fax Number	:

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

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	04/28/2026

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Directions to “ QUINN JIMERSON ” Practice Location

Language	Start Address	Practice Location

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