Provider Demographics
NPI:1013383470
Name:JIMENEZ, REBECCA JOY (MSN, RN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JOY
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24615 ARROW CYN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3231
Mailing Address - Country:US
Mailing Address - Phone:773-314-7392
Mailing Address - Fax:
Practice Address - Street 1:2515 CASTROVILLE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-3359
Practice Address - Country:US
Practice Address - Phone:210-433-0366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128770363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily