Individual
THERESA MIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
371 SHERIDAN DR, LEXINGTON, KY 40503-1820
(859) 402-7038
Mailing address
371 SHERIDAN DR, LEXINGTON, KY 40503-1820
(859) 402-7038
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
1056366
KY
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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