Healthcare Provider Details

I. General information

NPI: 1295829711
Provider Name (Legal Business Name): BRANDY SIMS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 16TH STREET NW
WASHINGTON DC
20036
US

IV. Provider business mailing address

1108 16TH STREET NW
WASHINGTON DC
20036
US

V. Phone/Fax

Practice location:
  • Phone: 202-347-8500
  • Fax: 202-783-1007
Mailing address:
  • Phone: 202-347-8500
  • Fax: 202-783-1007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN967171
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: