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Jennica Jimenez

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

5776 Mia Skye St, Las Vegas, NV 89148-5353

PECOS Enrollment

Based on the most recent information from CMS, provider Jennica Jimenez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1689422891
Provider Type
Individual
Full Name
Jimenez, Jennica
Gender
Female

Sole Proprietor
No
Enumeration Date
5/11/2024
Last Updated
5/11/2024

Contact Information

Practice Location

5776 Mia Skye St, Las Vegas, NV 89148-5353

(702) 635-2592

Unlisted Fax

Mailing Location

5776 Mia Skye St, Las Vegas, NV 89148-5353

(702) 635-2592

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 878334 Nevada

Jennica Jimenez

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Men'S Division Nv Pllc

Jackson, Joshua Grant

Mould, Danielle

Cooper, April Helen

Agregado, Joanne Balsicas

Adlerstein, Robert T

Thomas, Cristy Marie

Lopez-Sanglay, Anna Melisa C

Hampaye, Simin

Sahagun, Nancy