Provider Demographics
NPI:1144980319
Name:JIMENEZ, JACQUELINE (DC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8560 N GREEN HILLS RD STE 116
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1697
Mailing Address - Country:US
Mailing Address - Phone:816-205-8304
Mailing Address - Fax:816-306-2093
Practice Address - Street 1:8560 N GREEN HILLS RD STE 116
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1697
Practice Address - Country:US
Practice Address - Phone:816-205-8304
Practice Address - Fax:816-306-2093
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021037406111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic