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1104369610
PENNY MIMS
YPSILANTI, MI
NPI
1104369610
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MI 4704180055)
Enumeration Date
2016-12-01
Last Update Date
2016-12-01
Business Address
PENNY MIMS CNP
5301 E HURON RIVER DR
YPSILANTI, MI 48197-1051
Phone number: 734-712-8676
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Mailing Address
PENNY MIMS CNP
24 FRANK LLOYD WRIGHT DR PO BOX 0446 - LOBBY J
ANN ARBOR, MI 48105-9484
Phone number: 734-747-6766
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