Healthcare Provider Details

I. General information

NPI: 1053119917
Provider Name (Legal Business Name): BARBARA ANN SIMS REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4611 S 96TH ST STE 242
OMAHA NE
68127-1244
US

IV. Provider business mailing address

8807 N 158TH ST
BENNINGTON NE
68007-7498
US

V. Phone/Fax

Practice location:
  • Phone: 402-812-9108
  • Fax:
Mailing address:
  • Phone: 402-320-2787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number45928
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number45928
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: