Individual
SUSANA JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
2556 COVELL VILLAGE DR STE 120, EDMOND, OK 73003-9732
(405) 938-0700
(405) 861-8535
Mailing address
16109 BIG CYPRESS DR, EDMOND, OK 73013-1707
(612) 865-8717
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5123
OK
Other
Enumeration date
11/20/2023
Last updated
04/23/2026
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