Healthcare Provider Details

I. General information

NPI: 1205324357
Provider Name (Legal Business Name): LONA M SIMS AS HUMAN SERVICE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LONA MARIE WHITE CNA

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 DEFOORS FERRY RD NW APT F5
ATLANTA GA
30318-2344
US

IV. Provider business mailing address

106 GATEWOOD DR
ALBANY GA
31705-6304
US

V. Phone/Fax

Practice location:
  • Phone: 770-899-3525
  • Fax:
Mailing address:
  • Phone: 770-899-3525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number17051614
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: