Individual
MRS. JESSICA NICOLE MONTGOMERY MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
1027 BELLEVUE AVE, SUITE 107, SAINT LOUIS, MO 63117-1851
(314) 645-3743
(314) 647-7967
Mailing address
PO BOX 419052, SAINT LOUIS, MO 63141-9052
(314) 851-1000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2013004936
MO
Other
Enumeration date
03/06/2013
Last updated
06/26/2024
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