Healthcare Provider Details

I. General information

NPI: 1821982380
Provider Name (Legal Business Name): LORENA SASKIA SIMS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 BLUE RIDGE RD STE 218
RALEIGH NC
27612-8087
US

IV. Provider business mailing address

255 FAST PITCH LN
FOUR OAKS NC
27524-6119
US

V. Phone/Fax

Practice location:
  • Phone: 800-809-1265
  • Fax:
Mailing address:
  • Phone: 520-335-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5022322
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: