Individual
JAIME PIMENTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7903 PROVIDENCE RD, SUITE 100, CHARLOTTE, NC 28277-9720
(704) 316-4460
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-4460
(704) 316-4466
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5008315
NC
363LF0000X
Family Nurse Practitioner
5008315
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790142735
—
NC
Enumeration date
01/21/2016
Last updated
10/25/2020
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