Healthcare Provider Details

I. General information

NPI: 1891622403
Provider Name (Legal Business Name): JAMIE LYNN SIMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMES LYNN SIMS

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SAINT MICHAELS DR
SANTA FE NM
87505-7601
US

IV. Provider business mailing address

379 CALLE ELOY UNIT B
SANTA FE NM
87501-2472
US

V. Phone/Fax

Practice location:
  • Phone: 505-913-3361
  • Fax:
Mailing address:
  • Phone: 303-522-3879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2025-0088
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: