Individual
GABRIELLE D JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
4510 CHURCH RD, MOUNT LAUREL, NJ 08054-2210
(856) 439-0060
(856) 452-0344
Mailing address
4510 CHURCH RD, MOUNT LAUREL, NJ 08054-2210
(856) 439-0060
(856) 452-0344
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ00907900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14449580
CAQH
NJ
Enumeration date
03/27/2019
Last updated
08/11/2020
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