Individual
JIM BEAM NIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-1111
Mailing address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7199
(501) 526-7858
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
215092
AR
Other
Enumeration date
07/08/2024
Last updated
07/24/2024
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