Provider Demographics
NPI:1174250369
Name:NURSIE MIMI, LLC
Entity type:Organization
Organization Name:NURSIE MIMI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:ZENNI
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:513-498-3075
Mailing Address - Street 1:650 N. MIAMI AVENUE
Mailing Address - Street 2:P.O. BOX #63
Mailing Address - City:CLEVES
Mailing Address - State:OH
Mailing Address - Zip Code:45002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10743 HILLCREST CT
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-8579
Practice Address - Country:US
Practice Address - Phone:513-498-3075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NURSIE MIMI, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-07
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Single Specialty
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff DevelopmentGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty