Provider Demographics
NPI:1174952758
Name:SIMOKAITIS, SABRINA MARIA (FNP-C)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:MARIA
Last Name:SIMOKAITIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 OLD JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-3095
Mailing Address - Country:US
Mailing Address - Phone:678-490-0080
Mailing Address - Fax:678-490-0091
Practice Address - Street 1:65 OLD JACKSON RD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-3095
Practice Address - Country:US
Practice Address - Phone:678-490-0080
Practice Address - Fax:678-490-0091
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN198170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily