Provider Demographics
NPI:1043840234
Name:JIMENEZ, YVONNE CHAU (CRNA)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:CHAU
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:HUYNH
Other - Last Name:CHAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:830 AMLEY PL
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-6419
Mailing Address - Country:US
Mailing Address - Phone:980-225-4574
Mailing Address - Fax:
Practice Address - Street 1:4420 LAKE BOONE TRL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7505
Practice Address - Country:US
Practice Address - Phone:919-784-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6310367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered