Individual
CHARMAISE LYNETTE MIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
6380 BIGNER ROAD, BEAUMONT, TX 77708
(409) 351-0396
Mailing address
6380 BIGNER RD, 6380BIGNER RD, BEAUMONT, TX 77703
(409) 351-0396
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
227680
TX
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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