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Individual
JENNIFER JEAN MIMISH
Active
Individual
JENNIFER JEAN MIMISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM, WHNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP1553A
ID
364SW0102X
Women's Health Clinical Nurse Specialist
NP1553A
ID
367A00000X
Advanced Practice Midwife
CNM84A
ID
Other
Enumeration date
04/25/2015
Last updated
08/05/2022
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