Provider Demographics
NPI:1962900241
Name:JUMPP-MEHTA, KIMBERLY (FNP)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:JUMPP-MEHTA
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 1:16515 LEXINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2310
Mailing Address - Country:US
Mailing Address - Phone:281-980-6666
Mailing Address - Fax:
Practice Address - Street 1:16515 LEXINGTON BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2310
Practice Address - Country:US
Practice Address - Phone:281-980-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1026537363LF0000X
MI4704327730363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily