Provider Demographics
NPI:1588811608
Name:JIMENEZ, MIGDALIA (RN)
Entity Type:Individual
Prefix:MS
First Name:MIGDALIA
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 ETON DRIVE
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159
Mailing Address - Country:US
Mailing Address - Phone:518-482-0191
Mailing Address - Fax:518-591-0120
Practice Address - Street 1:820 5TH AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12182-2118
Practice Address - Country:US
Practice Address - Phone:515-237-2700
Practice Address - Fax:518-237-2708
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35374-1163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator