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Mimzy Vanessa Bohannon
Licensed Practical Nurse in Mishawaka, Indiana
NPI 1912692807

Mimzy Vanessa Bohannon is a Licensed Practical Nurse based in Mishawaka, IN. Mimzy Vanessa Bohannon practices in Mishawaka, IN. The NPI Number for Mimzy Vanessa Bohannon is 1912692807 and holds a License No. 27067174A (Indiana).

The current practice location address for Mimzy Vanessa Bohannon is 1540 Trinity Pl, Mishawaka, IN and can be reached out via phone at 574-272-9000 and via fax at 574-272-9298.

Location: 1540 Trinity Pl, Mishawaka, IN, 46545-5006
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912692807
Provider Name
Mimzy Vanessa Bohannon
Credential
Provider Entity Type
Individual
Gender
Female
Address
1540 Trinity Pl, Mishawaka, IN, 46545-5006
Phone Number
574-272-9000
Fax Number
574-272-9298
Provider Enumeration Date
04/07/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1540 Trinity Pl
City
Mishawaka
State
Indiana
Zip
46545-5006
Phone Number
574-272-9000
Fax Number
574-272-9298
person
Provider Business Mailing Address Details
Address
1540 Trinity Pl
City
Mishawaka
State
Indiana
Zip
46545-5006
Phone Number
574-272-9000
Fax Number
574-272-9298
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
27067174A (Indiana)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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