Basic Information
| Provider Information | |||||||||
| NPI: | 1639325806 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NJI NVUH MBAIMOUN | ||||||||
| FirstName: | JEANNETTE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1202 N MUSKOGEE PL | ||||||||
| Address2: | |||||||||
| City: | CLAREMORE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740173058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9183412556 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2509 WILDWOOD WAY | ||||||||
| Address2: | |||||||||
| City: | KELLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762628811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488724225 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2008 | ||||||||
| LastUpdateDate: | 08/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Q4653 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 282N00000X | Q4653 | TX | Y | Hospitals | General Acute Care Hospital |
No ID Information.