Provider Demographics
NPI:1427606888
Name:KARIMPANAMANNIL, JAIMY JOHN
Entity Type:Individual
Prefix:
First Name:JAIMY
Middle Name:JOHN
Last Name:KARIMPANAMANNIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 PEAR TREE LN
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-5631
Mailing Address - Country:US
Mailing Address - Phone:817-863-1253
Mailing Address - Fax:
Practice Address - Street 1:4003 LEMMON AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3737
Practice Address - Country:US
Practice Address - Phone:214-954-7389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily