Provider Demographics
NPI:1972271971
Name:LIM, JEWEL (BSN, RN)
Entity Type:Individual
Prefix:
First Name:JEWEL
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 NICHOL MILL LN APT 225
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8365
Mailing Address - Country:US
Mailing Address - Phone:615-456-4498
Mailing Address - Fax:
Practice Address - Street 1:427 NICHOL MILL LN APT 225
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8365
Practice Address - Country:US
Practice Address - Phone:615-456-4498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000107077163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse