Jennifer Jean Mimish, CNM, WHNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP1553A Issued in ID

Practice address

1301 S Millstream Dr
Nampa, ID 83686-4837

Phone

(208) 352-2290

NPI assigned

Apr 25, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Jennifer Jean Navarro Former name

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.mimish.1@26902.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gary Gregerson, M.D., P.a.

  • Obstetrics & Gynecology Physician
  • Nampa, ID
  • NPI 1255762506
  Medicare reassignment NPD
• Eros Health, LLC

  • Women's Health Nurse Practitioner
  • Boise, ID
  • NPI 1831827310
  NPD Authorized official
• Gary Gregerson MD PA

  • Obstetrics & Gynecology Physician
  • Nampa, ID
  • NPI 1902179914
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1821485012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S MILLSTREAM DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836864837",
            "telephone_number": "208-559-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S MILLSTREAM DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836864837",
            "telephone_number": "208-352-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMISH",
        "first_name": "JENNIFER",
        "middle_name": "JEAN",
        "credential": "CNM, WHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-25",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SW0102X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Women's Health",
            "state": "ID",
            "license": "NP1553A",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "ID",
            "license": "CNM84A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP1553A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "NAVARRO",
            "middle_name": "JEAN",
            "credential": "CNM, WHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sara Miller, M.S. CCC-SLP
• Matthew Duane Millican, MA, LPC
• Devin Alan Milliron, FNP
• Katherine Claire Mills, PHARMD
• Michael Holdcroft Millward, MD
• Brian Ora Minasian, PHARM D
• Mind Life Wellbeing Inc
• Mindful Healing Psychiatry of Idaho
• Mindful Moments Psychiatry, LLC
• Mindhaven Mental Health

• Nurse Practitioner in Nampa, ID
• Providers in Nampa, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.