PENNY MIMS CNP
NPI 1104369610
Nurse Practitioner in Ypsilanti, MI

Q: What is Penny Mims's NPI number?

The NPI number for Penny Mims is 1104369610. It was assigned to this individual provider in the NPPES registry on December 1, 2016.

Q: What is Penny Mims's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Penny Mims was last updated on December 1, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 01, 2016

5301 E HURON RIVER DR, YPSILANTI, MI 48197(734) 712-8676(734) 712-3855 Get Directions Write a Review

NPPES record last updated: December 1, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Penny Mims Cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENNY MIMS CNP (NPI 1104369610) is an individual nurse practitioner in Ypsilanti, Michigan, licensed in Michigan (4704180055) and active in the NPI registry since December 2016.

NPPES Registry Identity

NPI1104369610

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NamePENNY MIMSCredential: CNP

Location Address5301 E HURON RIVER DRYpsilanti, MI 48197-1051

Mailing Address24 Frank Lloyd Wright Dr, Po Box 0446 - Lobby JAnn Arbor, MI 48105-9484 · (734) 747-6766

Phone(734) 712-8676

Fax(734) 712-3855

Sole ProprietorNo

Enumeration DateDecember 1, 2016

✔ NPI 1104369610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MI · 4704180055

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

5301 E HURON RIVER DR, Ypsilanti, MI 48197

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRETTON LEE SCHLOESSER M.D.

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