Healthcare Provider Details

I. General information

NPI: 1528910668
Provider Name (Legal Business Name): JAMIE N MIMS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 MURRAH RD
NORTH AUGUSTA SC
29860-8986
US

IV. Provider business mailing address

473 MURRAH RD
NORTH AUGUSTA SC
29860-7607
US

V. Phone/Fax

Practice location:
  • Phone: 706-284-0597
  • Fax:
Mailing address:
  • Phone: 706-284-0597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number31531
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: