Individual
VICTORIA HARRISON MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1857 WOODDALE BLVD, BATON ROUGE, LA 70806-1510
(800) 640-3451
Mailing address
PO BOX 1200, PLEASANT GROVE, UT 84062-1200
(800) 640-3451
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
224005
LA
Other
Enumeration date
01/26/2022
Last updated
11/06/2024
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