Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 200701878 | NC |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 2007-01878 | NC |
NPI | 1336325232 |
---|---|
Provider Name | Virginia Cecile Duany Jimenez |
First Address | Newton, NC 28658-9715 |
Second Address | Newton, NC 28658 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2008 |
Last Update Date | 28/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
148G7 | NC BLUE CROSS BLUE SHIELD (01) | NC |
2007-01878 | LICENSE (01) | NC |
5908876 | (05) | NC |
FD0614443 | DEA (01) | NC |