Provider Demographics
NPI:1326280900
Name:CHIMENTO, JENNIFER S (FNP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:CHIMENTO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 BATTERY WAY
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-2138
Mailing Address - Country:US
Mailing Address - Phone:770-490-2372
Mailing Address - Fax:
Practice Address - Street 1:5775 PEACHTREE DUNWOODY RD STE 425
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1556
Practice Address - Country:US
Practice Address - Phone:844-403-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA170766363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily