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NPI Code Detail

MEDICARE: MR. BRANDON SIMS APN

MEDICARE:  MR. BRANDON  SIMS  APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner5856336TN

General Provider Information

NPI Number : 1568699858
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRANDON SIMS APN
Provider Business Mailing Address
First Line : 57 WINSTON PL
Second Line :
City : JACKSON
State : TN
Zip : 38305-1311
Country : US
Telephone Number : 731-984-8400
Fax Number : 731-984-8305
Provider Business Practice Location Address
First Line : 2075 PLEASANT PLAINS EXT RD
Second Line :
City : JACKSON
State : TN
Zip : 38305-6087
Country : US
Telephone Number : 731-984-8400
Fax Number : 731-984-8305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2009
Last Update Date : 06/15/2009

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