Integrative Hormone Health, Vascular Safety, and Chiropractic Integration: A Systems-Based, Evidence-Informed Guide

 

Abstract

In this educational post, I, Dr. Alexander Jimenez, DC, APRN, FNP-BC, CFMP, IFMCP, ATN, CCST, present a comprehensive, systems-based approach to women’s and men’s hormone health, venous thromboembolism (VTE) risk management, pain and sleep optimization, and clinic workflows that prevent crises. Drawing on recent findings from leading researchers and my clinical observations from El Paso and beyond, I explain:

• Why non-oral hormone routes generally reduce VTE risk compared with oral formulations, and how to assess clotting risk with precision.

• How physiologic progesterone supports abnormal uterine bleeding (AUB), perimenopausal sleep, and mood stability.

• How to choose between oral, vaginal, and transdermal progesterone and estradiol, and why dose, route, and timing matter.

• How testosterone therapy can be optimized with smaller, more frequent dosing to minimize erythrocytosis, acne, mood swings, and hair changes.

• How integrative chiropractic care complements endocrine and vascular care by improving autonomic tone, pain control, sleep quality, and movement efficiency.

• Why structured clinical systems—scheduling the next visit, checklists, early follow-up, and culture-driven antimicrobial stewardship—improve safety and outcomes.

I translate physiology into practical algorithms, discuss imaging and biopsy decision points, outline lab monitoring cadences, and integrate chiropractic strategies that stabilize the autonomic nervous system and reduce inflammatory burden. The result is an actionable, patient-centered roadmap that personalizes care, reduces crises, and improves quality of life.

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My Integrative Philosophy: Aligning Systems, Physiology, and Patient Priorities

As a clinician trained in functional medicine, advanced practice nursing, and chiropractic care, I’ve learned that outcomes are driven by two powerful levers: the biology of hormones, sleep, inflammation, and autonomic tone; and the systems that reliably deliver care. When we align these levers—clear workflows, individualized hormone plans, and integrative chiropractic—we lower sympathetic overload, stabilize endocrine axes, and sustain progress.

Key pillars in my clinics:

• A constitutional workflow that standardizes intake, risk screens, decision points, and follow-up.

• Precision endocrine evaluation with target-driven dosing, route selection, and pacing.

• Integrative chiropractic care to modulate autonomic tone, reduce pain, and improve sleep and recovery.

• Early, structured follow-ups and patient education that prevent drop-off and avert the need for crisis care.

Why this works:

• The hypothalamic–pituitary–ovarian (HPO) and hypothalamic–pituitary–gonadal (HPG) axes are sensitive to stress, sleep, and inflammation. Reducing allostatic load stabilizes cycles and mood while improving response to hormone therapy (Nillni et al., 2021).

• Standardized care pathways reduce missed checkpoints and improve outcomes across chronic conditions (Institute for Healthcare Improvement, 2020).

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Hormone Therapy Safety: Why Route, Dose, and Tempo Shape VTE Risk

The hepatic first-pass effect and clotting biology

Oral estrogens undergo significant first-pass metabolism, upregulating hepatic synthesis of clotting factors and altering C-reactive protein and triglycerides. By bypassing portal circulation, transdermal 17β-estradiol produces less hepatic stimulation and thus less prothrombotic signaling, a pattern consistently observed across large cohort studies (Canonico et al., 2007; Scarabin, 2018; Vinogradova et al., 2019; Shufelt & Manson, 2021).

Clinical translation:

• I prefer non-oral routes for most therapy initiations in patients with clotting risk or cardiometabolic concerns.

• I choose micronized progesterone when uterine protection is needed, given its more favorable VTE and metabolic profiles compared with some synthetic progestins (Scarabin, 2018; North American Menopause Society, 2022).

VTE risk management algorithm:

• Baseline stratification: personal/family VTE, surgery/immobility, migraine with aura, smoking, obesity, autoimmune or inflammatory disease, cancer, and medications that raise risk.

• Labs: CBC (hematocrit), CMP, lipids, HbA1c, TSH, ferritin, CRP; consider thrombophilia testing when indicated.

• Route: prefer transdermal estradiol in elevated-risk profiles; coordinate with hematology if prior hormone-associated VTE (Martinelli & Bucciarelli, 2022).

• Education: red-flag symptoms (unilateral leg swelling, sudden dyspnea, pleuritic chest pain).

• Follow-up cadence: 4–8 weeks after initiation, then 3–6 months, then annually, with individualization based on risk.

Why “go low and go slow”:

• Early lab perturbations often reflect short-term adaptation; overreacting can induce iatrogenic swings. I adjust thoughtfully unless red flags appear (Shufelt & Manson, 2021).

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Women’s Health Foundations: AUB, Perimenopause, and Progesterone’s Role

Endometrial physiology and the progesterone counterbalance

The endometrium proliferates under estrogen and stabilizes under progesterone. Unopposed estrogen raises hyperplasia risk and drives heavy or irregular bleeding. Physiologic progesterone stabilizes the endometrium, downregulates estrogen receptors, and organizes shedding—reducing thickness and breakthrough bleeding (Maybin & Critchley, 2015; ACOG, 2013; NICE, 2018).

Sleep and mood synergy:

• Oral micronized progesterone’s metabolite allopregnanolone modulates GABA-A receptors, improving sleep continuity and decreasing nocturnal awakenings in perimenopause (Baker et al., 2015; Shulman et al., 2018).

How I choose the formulation:

• Oral micronized progesterone: excellent for sleep benefits; bedtime dosing leverages sedative metabolites (Baker et al., 2015).

• Vaginal progesterone: robust endometrial exposure with fewer systemic sedative effects; ideal when uterine targeting is desired or oral sedation is intolerable (Stanczyk et al., 2013).

• Transdermal progesterone: inconsistent endometrial opposition at common cosmetic doses; I do not rely on it for uterine protection (Wren et al., 2000; Stute et al., 2016).

Practical dosing:

• Common start: 200 mg oral micronized progesterone at bedtime during the luteal phase or nightly depending on cycle status and goals (NICE, 2018; Prior, 2018).

• Reassess at 4–6 weeks: bleeding pattern, sleep quality, side effects; adjust dose, timing, or route.

Imaging and biopsy decision points:

• Transvaginal ultrasound for persistent AUB, suspected fibroids/polyps, or stripe assessment; postmenopausal stripe ≤4 mm has high NPV for endometrial cancer (ACOG Committee Opinion No. 734, 2018; Bradley et al., 2019).

• Biopsy: postmenopausal bleeding with stripe >4 mm, persistent AUB despite therapy, or risk factors (obesity, unopposed estrogen, tamoxifen) (Cohen et al., 2018).

My stepwise clinic approach:

• Rule out pregnancy in reproductive-age patients.

• CBC for anemia; TSH if thyroid history/symptoms.

• Ultrasound for structural causes; biopsy when indicated.

• Initiate progesterone when unopposed estrogen is likely, and malignancy is reasonably excluded or co-managed.

What patients ask (and my answers):

• “Will progesterone cause weight gain?” Micronized progesterone is generally weight-neutral; lifestyle and concurrent estrogen have larger effects (Stute et al., 2016).

• “Will it affect my mood or libido?” Many report mood stabilization and better sleep; I individualize dose and route (Fournier et al., 2008).

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Testosterone Optimization: Stable Signals Beat Peaks and Troughs

Why pharmacokinetic stability matters

Short-acting gels and infrequent, large injections result in high Cmax and deep troughs. Peaks can transiently upregulate cytokine pathways (e.g., IL-6), drive aromatization, and elevate DHT in susceptible follicles; troughs leave under-stimulated receptors, provoking fatigue, mood dips, and pain flares. I have observed this peak–trough roller coaster repeatedly; patients feel great early and crash days later. The correction is simple: create a flatter exposure curve.

My preferred strategies:

• Lower, more frequent subcutaneous dosing (e.g., twice weekly) or carefully titrated long-acting modalities to narrow Cmin–Cmax gaps (Bhasin et al., 2018; Kaminetsky et al., 2019; Pastuszak et al., 2015).

• Monitor total and free testosterone, SHBG, estradiol (LC-MS/MS when possible), DHT (if hair changes), hematocrit, lipids, insulin/glucose, and hs-CRP.

• Address modifiable drivers of aromatase activity: visceral adiposity, alcohol excess, and sleep deprivation.

Erythrocytosis and vascular safety:

• Testosterone stimulates erythropoietin production and increases red cell mass; excessive hematocrit increases blood viscosity and thrombotic risk at extremes (Grossman et al., 2018).

• If hematocrit rises: I reduce dose, shorten injection intervals to lower peaks, consider transdermal routes for susceptible patients, optimize sleep apnea and hydration, and reserve phlebotomy for persistent or symptomatic elevations.

Estradiol balance:

• Short-lived E2 elevations early in therapy are common; in asymptomatic patients, I observe rather than reflexively add aromatase inhibitors. If symptomatic (breast tenderness, mood lability) and E2 is clearly high, I may consider a short, time-limited, low-dose aromatase inhibitor with a defined stop date (Corona et al., 2020).

Acne and hair:

• Acne improves with steadier pharmacokinetics; I add topical keratolytics (e.g., salicylic or azelaic acid) as needed (Zouboulis et al., 2019).

• Hair shedding within 6–12 weeks can reflect telogen effluvium from hormonal normalization; if vertex/midline patterning appears, I assess DHT and collaborate on targeted strategies (Trüeb, 2015).

My clinical observations from El Paso:

• Switching from monthly depot injections to twice-weekly subcutaneous dosing consistently reduces fatigue, acne, and mood instability within 2–4 weeks; labs tighten, and day 5–6 “crashes” disappear. These outcomes are documented on my clinic platforms, dralexjimenez.com and the El Paso Chiropractic Blog.

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Integrative Chiropractic Care: Autonomic Regulation, Pain Relief, and Endocrine Synergy

Why neuromusculoskeletal care belongs in hormone and vascular plans

Chronic pain and sleep disruption amplify sympathetic drive, cortisol output, and inflammatory signaling, which in turn dysregulate gonadal and adrenal axes. Chiropractic care addresses this through precise manual therapies, mobility restoration, and movement prescriptions that recalibrate autonomic balance.

Core mechanisms and clinical effects:

• Autonomic regulation: Cervicothoracic and rib mechanics influence heart rate variability and vagal tone. Improved mechanoreception reduces sympathetic dominance and allostatic load, stabilizing HPO/HPG signaling (Clow & Fredhoi, 2006).

• Pain–sleep cycle: Lower nociceptive input enhances sleep architecture; because oral micronized progesterone’s GABAergic metabolites support sleep, the combination of better mechanics and bedtime dosing produces additive benefits (Baker et al., 2015).

• Movement and metabolism: Progressive resistance and zone 2 aerobic work improve insulin sensitivity and lower inflammatory tone—critical for AUB linked to anovulation or PCOS physiology (Dunaif, 2017; Kelley et al., 2012).

• Breathing and vagal tone: Diaphragmatic training and thoracic mobility improve CO2 tolerance and activate the cholinergic anti-inflammatory pathway, supporting sleep and lowering anxiety (Noble & Hochman, 2019).

In practice, I:

• Evaluate early for spinal and soft-tissue contributors to pain and poor sleep.

• Use gentle manipulation and soft-tissue work targeting the cervicothoracic junction, diaphragm attachments, and scapulothoracic rhythm to shift toward parasympathetic dominance.

• Prescribe progressive mobility stacks and resistance training to match recovery capacity and avoid cortisol spikes.

• Synchronize chiropractic and medical follow-ups to assess symptom modulation, HRV, sleep, and bleeding logs.

Clinical outcomes I see:

• Within 4–6 weeks, combined chiropractic care, aerobic work, and paced breathing reduce blood pressure and headache burden while improving sleep and stamina—aligned with literature on autonomic and endothelial benefits and mirrored in my clinic data.

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Systems That Prevent Crises: Scheduling, Checklists, and Communication

Why process beats heroics

When care lacks structure, patients fall through the cracks, especially during hormone adjustments. I aim for at least 90% of patients to leave with their next visit scheduled. This single system improves adherence, titration precision, and reassurance.

Operational steps that work:

• First-visit roadmap: detailed history, vitals, medication/supplement review, structured symptom index, and targeted labs.

• Side-effect playbooks: if oral progesterone causes daytime sedation, move dosing to bedtime; if insomnia persists, screen for apnea, caffeine timing, and pain drivers.

• Communication loops: if labs lag or symptoms flare, we proactively call with an action plan rather than wait.

Evidence base:

• Structured pathways reduce missed follow-ups and improve symptom control and adherence in women’s health (Institute for Healthcare Improvement, 2020; Matteson et al., 2019).

My patient communication scripts:

• If a patient cannot schedule an on-site appointment, we place a provisional appointment and adjust it later. Pre-commitment improves continuity and lowers anxiety.

• When travel or missed doses occur, we triage by phone, reinforce timing (e.g., bedtime progesterone), and reschedule promptly.

• If labs are delayed, we implement symptom-guided adjustments with a clear lab deadline and reminders.

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Diagnostic Precision: Ultrasound, Biopsy, and Targeted Labs

AUB and endometrial evaluation

I apply the following steps:

• Imaging: Transvaginal ultrasound to evaluate endometrial thickness, fibroids, and polyps; interpret thickness in the cycle context for premenopausal patients (Bradley et al., 2019).

• Biopsy: Postmenopausal bleeding with stripe >4 mm, persistent AUB, or high-risk features warrants tissue diagnosis (ACOG Committee Opinion No. 734, 2018; Cohen et al., 2018).

Thrombosis risk and hormone safety labs

Baseline and follow-up panels:

• CBC (hematocrit/hemoglobin), CMP, lipids, HbA1c, TSH, ferritin, CRP.

• Consider thrombophilia testing when clinical cues suggest it (Martinelli & Bucciarelli, 2022).

Testosterone monitoring

• Total and free testosterone, SHBG, estradiol (prefer LC-MS/MS when interference is suspected), DHT (if hair changes), hematocrit, lipids, insulin/glucose, and hs-CRP (Grossman et al., 2018; Bhasin et al., 2018).

Why measured cadence matters:

• Short-term changes (first 4–8 weeks) often normalize; I avoid “whiplash” adjustments unless necessary. From 8–12 weeks onward, enzymatic pathways such as aromatase and 5α-reductase settle to new set points, and tissue-level effects stabilize.

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Infection Stewardship and Early Complication Checks: Safety Nets That Save Time and Tissue

One-week safety check after procedures

Around days 7–14, inflammatory complications can emerge. I schedule a check within 5–7 days to detect disproportionate warmth, erythema, and tenderness early.

My protocol:

• Educate on red flags; use photo check-ins when in-person is not possible.

• Examine the entire incision and lymphatic drainage zones; assess vitals and systemic signs.

• If an abscess is suspected, prioritize drainage and culture before initiating or soon after starting antibiotics, when safe.

Culture-driven therapy:

• I avoid skipping cultures; this prevents prolonged, ineffective empiric exposure and antibiotic stacking. IDSA guidance supports incision and drainage with culture for purulent infections, with de-escalation when results return (Liu et al., 2011; Barlam et al., 2016).

Chiropractic coordination:

• While avoiding direct manipulation near healing tissue, I support adjacent regions, lymphatic flow, posture, and gait to reduce tissue stress and improve recovery.

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Cardiometabolic Precision: Antihypertensives, Exercise Capacity, and Hormone Goals

Beta-blockers, while critical for specific indications, are no longer first-line therapy for uncomplicated hypertension without compelling indications; they can blunt exercise tolerance and impede training gains that are critical for endocrine goals (Whelton et al., 2018; Messerli et al., 2017). When I see fatigue and low capacity on beta-blockers without a strong indication, I collaborate with primary care to reassess therapy. Improving training capacity amplifies hormone benefits by enhancing mitochondrial signaling, insulin sensitivity, and vascular health.

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Crohn’s Disease and Autoimmunity: Steroid-Sparing, Objective Monitoring, and Autonomic Care

Steroids can be lifesaving in acute flares, but they are not a long-term plan. My approach aligns with contemporary gastroenterology guidance:

• Confirm activity using fecal calprotectin, CRP, and endoscopy or imaging when appropriate.

• Employ steroid-sparing maintenance with immunomodulators or biologics for moderate-to-severe disease (Feagan et al., 2021; Rubin et al., 2019).

• Support barrier function with nutrition (e.g., omega-3s, zinc if low, vitamin D optimization, and soluble fiber as tolerated) and avoid aggressive abdominal techniques during flares (Lewis & Abreu, 2017).

Chiropractic and autonomic modulation:

• Thoracic mobility and diaphragmatic breathing improve vagal tone, reduce visceral hyperalgesia, and support sleep—key levers in reducing inflammatory burden and symptom amplification.

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Coaching Patients Through Transitions: Smoother On-Ramps, Fewer Drop-Offs

Medication transitions can create brief windows of side effects. I reduce risk by:

• Micro-titrations and timing changes on calm days, supported by sleep hygiene and paced breathing.

• In testosterone transitions (e.g., injections to pellets), I set expectations for 2–4 weeks of possible irritability, acne, or headaches in a subset of patients; I monitor total/free T, estradiol, SHBG, and hematocrit at baseline and 4–6 weeks post-change, avoiding stacked fast- and long-acting regimens unless clearly indicated.

In psychopharmacology collaborations, I apply small dose increments with temporary split dosing to reduce peak-related activation and withdrawal phenomena, coordinating drug–drug checks to avoid serotonergic or QTc risks.

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A Clinic Playbook: Stepwise, Reproducible Care

• Capture patients’ top three priorities and convert them into measurable outcomes and timelines.

• Schedule the next visit before patients leave; target ≥90% to maintain continuity.

• For AUB and perimenopausal symptoms, favor bedtime oral micronized progesterone and reassess at 4–6 weeks; consider vaginal routes when sedation is undesirable or uterine targeting is prioritized.

• In VTE-risk contexts, choose non-oral estradiol and micronized progesterone; educate on red flags and set a monitoring cadence.

• For testosterone therapy, prefer smaller, more frequent dosing to flatten peaks and protect against erythrocytosis, acne, mood swings, and hair changes.

• Integrate chiropractic care from day one to modulate autonomic tone, reduce pain, improve sleep, and enhance training response.

• After procedures, schedule a 5–7-day safety check; never skip cultures when drainage is performed; de-escalate antibiotics based on results.

• Use brief team huddles and checklists to lower cognitive load and strengthen reliability.

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Why This Approach Works: Physiological Coherence Meets Operational Discipline

• Physiological coherence: Stable endocrine signals, lower sympathetic tone, and improved sleep create a biologic environment that favors hormonal efficacy and vascular safety.

• Operational discipline: Early follow-up, checklists, and pre-booked appointments keep care on track and prevent avoidable crises.

• Patient partnership: Shared decision-making and transparent risk–benefit discussions build trust and adherence, especially when choosing hormone routes and doses.

My clinic data and observations reflect fewer crisis calls, steadier sleep, improved bleeding patterns, better exercise capacity, and higher satisfaction when these elements are consistently applied.

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References

• American College of Obstetricians and Gynecologists (ACOG). (2013). Management of abnormal uterine bleeding associated with ovulatory dysfunction.

• ACOG Committee Opinion No. 734. (2018). The role of transvaginal ultrasonography in evaluating the endometrium of women with postmenopausal bleeding.

• Baker, F. C., de Zambotti, M., Colrain, I. M., & Bei, B. (2015). Sleep problems during the menopausal transition: Prevalence, impact, and management.

• Barlam, T. F., et al. (2016). Implementing an antibiotic stewardship program: Guidelines by the IDSA and SHEA.

• Bhasin, S., et al. (2018). Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline.

• Bradley, L. D., & Gueye, N.-A. (2019). Abnormal uterine bleeding in premenopausal women.

• Canonico, M., et al. (2007). Hormone therapy and venous thromboembolism among postmenopausal women: Impact of route of estrogen administration and progestogens.

• Clow, A., & Fredhoi, C. (2006). Autonomic function and health.

• Cohen, P. A., et al. (2018). Endometrial cancer risk and evaluation.

• Corona, G., et al. (2020). Testosterone therapy: What we have learned from systematic reviews and meta-analyses of clinical trials.

• Dunaif, A. (2017). Insulin resistance and the polycystic ovary syndrome revisited.

• El Khoudary, S. R., et al. (2020). Cardiovascular health in the menopausal transition.

• Fournier, A., et al. (2008). Use of different postmenopausal hormone therapies and risk of breast cancer.

• Feagan, B. G., et al. (2021). Strategies to achieve remission in Crohn’s disease.

• Grossman, M., Matsumoto, A. M., & Swerdloff, R. S. (2018). Safety of testosterone replacement therapy in men.

• Institute for Healthcare Improvement. (2020). Care pathways and reliability in healthcare.

• Kaminetsky, J., et al. (2019). Subcutaneous testosterone: Pharmacokinetics and patient-reported outcomes.

• Kelley, G. A., Kelley, K. S., & Kohrt, W. M. (2012). Exercise and lipids in postmenopausal women.

• Lewis, J. D., & Abreu, M. T. (2017). Diet as a trigger or therapy for inflammatory bowel diseases.

• Liu, C., et al. (2011; 2014 update). Clinical practice guidelines for the diagnosis and management of skin and soft tissue infections.

• Martinelli, I., & Bucciarelli, P. (2022). Hormone therapies and venous thrombosis risk: Current concepts.

• Maybin, J. A., & Critchley, H. O. D. (2015). Menstrual physiology: Understanding the endometrium.

• Messerli, F. H., et al. (2017). Beta-blockers in hypertension: Is there a rationale?

• NICE. (2018). Heavy menstrual bleeding: Assessment and management.

• Nillni, Y. I., et al. (2021). Stress, HPA axis, and menstrual cycle irregularities.

• North American Menopause Society. (2022). The 2022 hormone therapy position statement.

• Noble, D. J., & Hochman, S. (2019). Pulmonary afferent activity during slow, deep breathing and autonomic changes.

• Pastuszak, A. W., et al. (2015). Testosterone therapy and subcutaneous dosing strategies.

• Prior, J. C. (2018). Progesterone for symptomatic perimenopause treatment.

• Renoux, C., Dell’Aniello, S., & Suissa, S. (2010). Transdermal and oral hormone replacement therapy and the risk of stroke.

• Rubin, D. T., et al. (2019). ACG clinical guideline: Ulcerative colitis in adults (principles applicable to Crohn’s).

• Scarabin, P.-Y. (2018). Hormones and venous thromboembolism among postmenopausal women.

• Shufelt, C. L., & Manson, J. E. (2021). Menopausal hormone therapy and cardiovascular disease: Formulation, dose, and route.

• Shulman, L. P., et al. (2018). Micronized progesterone in perimenopause/menopause.

• Stanczyk, F. Z., et al. (2013). Progesterone and progestins in hormone therapy: Pharmacology and clinical applications.

• Stute, P., et al. (2016). The impact of micronized progesterone on the endometrium and breast.

• Vinogradova, Y., Coupland, C., & Hippisley-Cox, J. (2019). HRT and risk of venous thromboembolism.

• Whelton, P. K., et al. (2018). ACC/AHA guideline for high blood pressure in adults.

• Wren, B. G., et al. (2000). Transdermal progesterone creams: Do they deliver?

• Zouboulis, C. C., et al. (2019). Pathogenesis and treatment of acne and role of androgens.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, and physical medicine, as well as wellness, sensitive health issues, and functional medicine articles, topics, and discussions. We provide and facilitate clinical collaboration with specialists across disciplines. Each specialist is governed by their professional scope of practice and the jurisdiction in which they are licensed. We utilize functional health and wellness protocols to treat and support care for musculoskeletal injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters and issues that directly or indirectly support our clinical scope of practice. Our office has made a reasonable effort to provide supportive citations and identify relevant research studies for our posts. We provide copies of supporting research studies upon request to regulatory boards and the public.

We are here to help you and your family.

Blessings

Dr. Alex Jimenez, DC, MSACP, APRN, FNP-BC*, CCST, IFMCP, CFMP, ATN

email: coach@elpasofunctionalmedicine.com

Multidisciplinary Licensing & Board Certifications:

Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License #: TX5807, Verified: TX5807
New Mexico DC License #: NM-DC2182, Verified: NM-DC2182

Multi-State Advanced Practice Registered Nurse (APRN*) in Texas & Multi-States 
Multi-State Compact APRN License by Endorsement (42 States)
Texas APRN License #: 1191402, Verified: 1191402 *
Florida APRN License #: 11043890, Verified:  APRN11043890 *
New York APRN License #: N25929, Verified:  APRN-N25929*
License Verification Link: Nursys License Verifier
* Prescriptive Authority Authorized

ANCC FNP-BC: Board Certified Nurse Practitioner*
Compact Status: Multi-State License: Authorized to Practice in 40 States*

Graduate with Honors: ICHS: MSN-FNP (Family Nurse Practitioner Program)
Degree Granted. Master's in Family Practice MSN Diploma (Cum Laude)

Dr. Alex Jimenez, DC, APRN, FNP-BC*, CFMP, IFMCP, ATN, CCST
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