National Provider Identifier

Mimi Chan, NP

Mimi Chan, NP is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Elmira, NY and a listed phone number of (607) 737-4130.

NPI 1700469442Elmira, NYNurse Practitioner

Profile Overview

NPI
1700469442
Provider Type
Individual
Primary Specialty
Nurse Practitioner
Enumeration Date
April 30, 2021
Last Updated
April 30, 2021

Practice Location

  • 600 Roe Ave # 1A
  • Elmira, NY 14905-1629

Phone: (607) 737-4130

Mailing Address

  • 571 Saint Josephs Blvd Fl 2
  • Elmira, NY 14901-3230

Specialties

  • Nurse Practitioner (363L00000X)
Full Record
NPI
1700469442
Entity Type
Individual
Last Name
Chan
First Name
Mimi
Credential
NP
Mailing Street Address
571 Saint Josephs Blvd Fl 2
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14901-3230
Mailing Country
US
Mailing Phone
(607) 271-2094
Mailing Fax
(607) 271-2071
Practice Street Address
600 Roe Ave # 1A
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14905-1629
Practice Country
US
Practice Phone
(607) 737-4130
Enumeration Date
April 30, 2021
Last Updated
April 30, 2021
Sex
Female
Sole Proprietor
No
Certification Date
March 19, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Nurse Practitioner (363L00000X)