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NPI Code Detail

MEDICARE: SHANNON MARIE SIMS APRN

MEDICARE: SHANNON MARIE SIMS APRN
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 PractitionerAPRN11002992FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962064832
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON MARIE SIMS APRN
Provider Business Mailing Address
First Line : PO BOX 2699
Second Line : ATTN SHMG HPE
City : PENSACOLA
State : FL
Zip : 32513-2699
Country : US
Telephone Number : 850-416-4730
Fax Number : 850-416-4703
Provider Business Practice Location Address
First Line : 6314 N 9TH AVE
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-7320
Country : US
Telephone Number : 850-416-4730
Fax Number : 850-416-4703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2019
Last Update Date : 07/01/2019

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