Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | APRN.CNP.0027322 | OH |
NPI | 1053928101 |
---|---|
Provider Name | Andrea Sims |
First Address | Newark, OH 43055-1822 |
Second Address | Newark, OH 43055-1822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2020 |
Last Update Date | 01/10/2020 |