Provider Demographics
NPI:1912429184
Name:JIMENEZ, HEATHER DIMAGGIO (FNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:DIMAGGIO
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 MAGNOLIA COVE DR STE 106
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-2252
Mailing Address - Country:US
Mailing Address - Phone:936-270-4949
Mailing Address - Fax:
Practice Address - Street 1:4501 MAGNOLIA COVE DR STE 106
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-2252
Practice Address - Country:US
Practice Address - Phone:936-270-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134386363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily