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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LISA L MIMS

Active Sole Proprietor

LISA L MIMS is a Custodial Care Facility healthcare provider located in FUQUAY VARINA, North Carolina. NPI 1750019725 is currently active in the NPPES registry. Verify at CMS.

Custodial Care Facility · FUQUAY VARINA, NC

Registration Details

NPI Number
1750019725
Provider Type
Individual
Gender
Female
NPI Issued
Aug 9, 2022 (4.0227494452834 yrs)
Last Updated
Aug 9, 2022
Sole Proprietor
Yes

Practice Information

Address
504 BURTON ST
FUQUAY VARINA, NC, 275261608
Browse NC providers · Browse ZIP 27526
Phone
9197538042
Fax
9197627621
Primary Specialty
Custodial Care Facility
311Z00000X
Additional Specialty
Custodial Care Facility
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.