MEDICARE: MS. OLIVIA SIMS FNP,C

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
1	363LF0000X	Family Nurse Practitioner	26NN08101800	NJ

General Provider Information

NPI Number	:	1427107903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. OLIVIA SIMS FNP,C

Provider Business Mailing Address
First Line	:	811 FISCHER BLVD
Second Line	:	APT PB5
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-4605
Country	:	US
Telephone Number	:	732-929-3440
Fax Number	:	732-270-4949

Provider Business Practice Location Address
First Line	:	65 BERGEN ST STE 1118
Second Line	:	UMDNJ SCHOOL OF NURSING
City	:	NEWARK
State	:	NJ
Zip	:	07107-3001
Country	:	US
Telephone Number	:	973-972-7217
Fax Number	:	973-972-7853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	02/15/2017

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