Provider Demographics
NPI:1962774372
Name:KIMANI, JACINTA WANJIRU (NP-C)
Entity type:Individual
Prefix:MS
First Name:JACINTA
Middle Name:WANJIRU
Last Name:KIMANI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 TREE TOP LN
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2811
Mailing Address - Country:US
Mailing Address - Phone:205-381-1433
Mailing Address - Fax:
Practice Address - Street 1:1904 TREE TOP LN
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-2811
Practice Address - Country:US
Practice Address - Phone:205-381-1433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-115537363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily