Healthcare Provider Details

I. General information

NPI: 1407728025
Provider Name (Legal Business Name): ELAINE SIMS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 S OLIVE ST
PINE BLUFF AR
71601-6518
US

IV. Provider business mailing address

5803 S PLUM ST
PINE BLUFF AR
71603-7658
US

V. Phone/Fax

Practice location:
  • Phone: 870-540-1200
  • Fax:
Mailing address:
  • Phone: 870-540-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA006261
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: