MEDICARE: GABRIEL SIMS ARNP

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
1	163W00000X	Registered Nurse	RN00141942	WA
2	363LF0000X	Family Nurse Practitioner	AP 60598228	WA

General Provider Information

NPI Number	:	1659751279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL SIMS ARNP

Provider Business Mailing Address
First Line	:	3290 W 19TH AVE
Second Line	:
City	:	KENNEWICK
State	:	WA
Zip	:	99337-2318
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1776 FOWLER ST
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-4833
Country	:	US
Telephone Number	:	509-735-9355
Fax Number	:	509-222-1151

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2015
Last Update Date	:	11/12/2020

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