Provider Demographics
NPI:1194614693
Name:QUIXAN JIMON, ALICIA ROSARIO
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:ROSARIO
Last Name:QUIXAN JIMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 N KIMBALL ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-2551
Mailing Address - Country:US
Mailing Address - Phone:308-850-5003
Mailing Address - Fax:
Practice Address - Street 1:911 BAUMANN DR APT 1
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4408
Practice Address - Country:US
Practice Address - Phone:308-675-2189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant