Provider Demographics
NPI:1043387756
Name:JIMENEZ, PAMELA WOODS (RN, MSN, CFNP, CPNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:WOODS
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:RN, MSN, CFNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 SHALLCROSS AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-2344
Mailing Address - Country:US
Mailing Address - Phone:302-655-4471
Mailing Address - Fax:302-655-2005
Practice Address - Street 1:1700 SHALLCROSS AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-2344
Practice Address - Country:US
Practice Address - Phone:302-655-4471
Practice Address - Fax:302-655-2005
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEL1-0014282163W00000X
DELG-0000138363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse