Provider Demographics
NPI:1982456166
Name:JIMMERSON, NEHEMIAH
Entity type:Individual
Prefix:
First Name:NEHEMIAH
Middle Name:
Last Name:JIMMERSON
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:PO BOX 880542
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94188-0542
Mailing Address - Country:US
Mailing Address - Phone:415-816-6561
Mailing Address - Fax:
Practice Address - Street 1:8043 CARLISLE WAY
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-8587
Practice Address - Country:US
Practice Address - Phone:415-816-6561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula