Individual
KEVIN JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
100 GRAND ST, NEW BRITAIN, CT 06052-2016
(860) 224-5900
Mailing address
16 ORCHARD LN, WATERBURY, CT 06705-1732
(203) 558-3952
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
9371
CT
Other
Enumeration date
01/11/2021
Last updated
01/11/2021
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