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NPI Code Detail

MEDICARE: MRS. HOLLY JO SIMS ARNP

MEDICARE: MRS. HOLLY JO SIMS ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerARNP9186215FL
2363LP2300XPrimary Care Nurse PractitionerAPRN9186215FL

General Provider Information

NPI Number : 1134443484
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HOLLY JO SIMS ARNP
Provider Business Mailing Address
First Line : 4250 HOSPITAL DR
Second Line :
City : MARIANNA
State : FL
Zip : 32446-1917
Country : US
Telephone Number : 850-482-0017
Fax Number : 850-482-6617
Provider Business Practice Location Address
First Line : 4295 3RD AVE
Second Line :
City : MARIANNA
State : FL
Zip : 32446-2120
Country : US
Telephone Number : 850-482-0017
Fax Number : 850-526-5002
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2010
Last Update Date : 11/22/2022

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