Individual
MS. CHANTEL THERESE P JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11070 N 24TH AVE, PHOENIX, AZ 85029-4705
(602) 795-9480
Mailing address
11070 N 24TH AVE, PHOENIX, AZ 85029-4705
(602) 795-9480
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN195007
AZ
363L00000X
Nurse Practitioner
Primary
260688
AZ
Other
Enumeration date
12/07/2020
Last updated
07/15/2021
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