JESSICA CAROLINE MIMBS (NPI# 1932654563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932654563 |
| Entity Type | Individual |
| Full Name | JESSICA CAROLINE MIMBS |
| Other Name | JESSICA CAROLINE BROWN |
| Credential | RN, MSN, FNP-C |
| Practice Address |
1600 Towne Lake Pkwy Woodstock GA 30189-1585 |
| Mailing Address |
125 Walnut Hall Circle Woodstock GA 30189 |
| Practice Telephone | 8663892727 |
| Practice Fax Number | 4016529787 |
| Mailing Telephone | 4072476442 |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2017-04-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | RN239259 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN239259 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN239259 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GA NP LICENSE | RN239259 | 01 |
| Street Address |
1600 TOWNE LAKE PKWY |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30189-1585 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649374570 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 | 2006-09-12 |
| 1710593389 | Paule Constant | Nurse Practitioner | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 | 2020-09-19 |
| 1487138863 | Naomi Morson | Nurse Practitioner | 1600 Towne Lake Pkwy, Woodstock, GA 30189 | 2018-09-20 |
| 1962988956 | Randy Olinger | Nurse Practitioner | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 | 2018-07-13 |
| 1407364540 | Abdul Raheem Mohammed | Pharmacist | 1600 Towne Lake Pkwy, Woodstock, GA 30189 | 2018-01-10 |
| 1134573686 | Sarah Adams-long | Nurse Practitioner | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 | 2016-04-21 |
| 1033580030 | Cristin Cay Chester | Nurse Practitioner | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 | 2015-10-15 |
| 1811366560 | Farrah Kasemkhani | Pharmacist | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 | 2015-09-23 |
| 1083081350 | Raymond Mertel | Pharmacist | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 | 2015-08-21 |
| 1689041980 | Kamran Moradi | Pharmacist | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 | 2015-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
| 1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
| 1548770449 | Chandra Johnson | Nurse Practitioner | 295 Molly Lane Ste 150, Woodstock, GA 30189 | 2017-10-05 |
| 1083133912 | Amanda Bostock Sowisdral | Physician Assistant | 250 Parkbrooke Pl Ste 300, Woodstock, GA 30189 | 2017-09-12 |
| 1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
| 1265954788 | Vicky Morton Bryan | Nurse Practitioner | 422 Sycamore Trail, Woodstock, GA 30189 | 2017-07-17 |
| 1063933588 | Marietta Eye Clinic, Pa | Optometrist | 2990 Eagle Dr Ste 110, Woodstock, GA 30189 | 2017-07-06 |
| 1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
| 1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
| 1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
| Find all providers in zip 30189 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952927493 | Lauren Galbraith Agee | Nurse Practitioner | 900 Towne Lake Pkwy Ste 104, Woodstock, GA 30189-1603 | 2020-06-21 |
| 1922620798 | Brandy Bentley | Nurse Practitioner | 9670 Main St, Woodstock, GA 30188-3916 | 2020-05-14 |
| 1609407600 | Holly Caroline Walsh | Nurse Practitioner | 325 Alcovy Way, Woodstock, GA 30188-3329 | 2020-01-29 |
| 1366095135 | Stephanie Fagbemi | Nurse Practitioner | 295 Molly Ln Ste A101, Woodstock, GA 30189-3760 | 2019-07-22 |
| 1497244875 | Tarsha Chamaine Kennedy | Nurse Practitioner | 400 Sycamore Ln Apt 302, Woodstock, GA 30188-7318 | 2018-05-01 |
| 1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
| 1912407719 | Qrc 360 Enterprises | Nurse Practitioner | 12195 Highway 92 Ste 144, Woodstock, GA 30188-3603 | 2018-02-19 |
| 1942700729 | Jiwon Yoo | Nurse Practitioner | 310 Gold Creek Trl Ste 200, Woodstock, GA 30188-5436 | 2018-02-18 |
| 1811418650 | Sophia A Kennedy | Nurse Practitioner | 203 Woodpark Pl Ste 102, Woodstock, GA 30188-3705 | 2017-07-02 |
| 1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
| Find all providers in WOODSTOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.