Healthcare Provider Details

I. General information

NPI: 1306283577
Provider Name (Legal Business Name): LISA WALKER SIMS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA CHANEY FNP-BC

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 09/17/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10110 SOUTH 7650 EAST
CROW AGENCY MT
59022-0009
US

IV. Provider business mailing address

PO BOX 9
CROW AGENCY MT
59022-0009
US

V. Phone/Fax

Practice location:
  • Phone: 406-638-3348
  • Fax: 406-638-3375
Mailing address:
  • Phone: 406-638-3348
  • Fax: 406-638-3375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-077167
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-077167
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: