Provider Demographics
NPI:1124906078
Name:BIMBI, JENNA
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:BIMBI
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 ROUTE 3
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-2328
Mailing Address - Country:US
Mailing Address - Phone:973-777-6767
Mailing Address - Fax:
Practice Address - Street 1:780 ROUTE 3
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-2328
Practice Address - Country:US
Practice Address - Phone:973-777-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR18529800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse