Individual provider · NPI-1

Jessica Jim

Technician, Other · Las Cruces, NM

NPI number1235660143
StatusActive
Last updated in NPPESMar 22, 2017

Details

NPI
1235660143
Entity type
Individual (NPI-1)
Name
Ms. Jessica Jim
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 22, 2017
Last updated
Mar 22, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
247200000X Technician, OtherPM000110NMYes

Practice location

920 N Alameda Blvd
Ste 2
Las Cruces, NM 88005-2291

Phone 575-636-8406

Mailing address

920 N Alameda Blvd
Ste 2
Las Cruces, NM 88005-2291

Phone 575-636-8406

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