Provider Demographics
NPI:1215680376
Name:JMAIM DME PLLC
Entity type:Organization
Organization Name:JMAIM DME PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-C, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABAWI
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:480-200-7455
Mailing Address - Street 1:4637 E REINS RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-9515
Mailing Address - Country:US
Mailing Address - Phone:480-200-7455
Mailing Address - Fax:
Practice Address - Street 1:3755 S GILBERT RD STE 109
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-2008
Practice Address - Country:US
Practice Address - Phone:480-200-7455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JMA INTEGRATED MEDICINE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-30
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center