Healthcare Provider Details

I. General information

NPI: 1073751657
Provider Name (Legal Business Name): JEAN WRIGHT-SIMS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2009
Last Update Date: 02/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E 6TH ST SUITE 606
PANAMA CITY FL
32401-3661
US

IV. Provider business mailing address

801 E 6TH ST SUITE 606
PANAMA CITY FL
32401-3661
US

V. Phone/Fax

Practice location:
  • Phone: 850-785-2229
  • Fax: 850-785-1806
Mailing address:
  • Phone: 850-785-2229
  • Fax: 850-785-1806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN171192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: