Provider Demographics
NPI:1437428729
Name:FIMBRES, JENNIFER ALEXA (NP-C)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:ALEXA
Last Name:FIMBRES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ALEXA
Other - Last Name:SHULICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:10633 E SINGING CANYON DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-6010
Mailing Address - Country:US
Mailing Address - Phone:520-704-5538
Mailing Address - Fax:
Practice Address - Street 1:3611 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1534
Practice Address - Country:US
Practice Address - Phone:520-881-0636
Practice Address - Fax:520-881-0637
Is Sole Proprietor?:No
Enumeration Date:2011-12-15
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily