Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 2014016879 | IN |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 71005197A | IN |
NPI | 1013310879 |
---|---|
Provider Name | Lisa Kathleen Sims |
First Address | Indianapolis, IN 46268-3129 |
Second Address | Indianapolis, IN 46260-1992 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2014 |
Last Update Date | 28/10/2014 |