Provider Demographics
NPI:1174063812
Name:SIMS, JAMIE (CRNP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1958 AL HIGHWAY 157
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-0609
Mailing Address - Country:US
Mailing Address - Phone:256-737-2090
Mailing Address - Fax:256-737-2091
Practice Address - Street 1:1958 AL HIGHWAY 157
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0609
Practice Address - Country:US
Practice Address - Phone:256-737-2090
Practice Address - Fax:256-737-2091
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-097311363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL219976Medicaid
AL529601950Medicaid