Individual
EMILY NICOLE JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-8000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
23.004806
CT
363AM0700X
Medical Physician Assistant
Primary
PA.0007761
CO
Other
Enumeration date
05/01/2020
Last updated
04/24/2023
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