Healthcare Provider Details

I. General information

NPI: 1427772649
Provider Name (Legal Business Name): MIKAYLA ANN RIMMER MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS MIKAYLA ANN BLANKENSHIP

II. Dates (important events)

Enumeration Date: 09/30/2022
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 OLD MOCKSVILLE RD
STATESVILLE NC
28625-1953
US

IV. Provider business mailing address

PO BOX 1845
STATESVILLE NC
28687-1845
US

V. Phone/Fax

Practice location:
  • Phone: 704-838-8237
  • Fax: 704-924-5358
Mailing address:
  • Phone: 704-873-4277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number315459
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5017001
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: