Individual
MS. PRISCILLA JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
710 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-2379
(586) 944-5827
Mailing address
710 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-2379
(617) 379-0434
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704230272NSA200YP
MI
Other
Enumeration date
01/08/2021
Last updated
01/23/2022
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