Provider Demographics
NPI:1053058545
Name:SIMS, ELIZABETH ANN (RN, PHN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:SIMS
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2941 4TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5901
Mailing Address - Country:US
Mailing Address - Phone:888-789-9636
Mailing Address - Fax:888-909-6855
Practice Address - Street 1:2941 4TH AVE STE B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5901
Practice Address - Country:US
Practice Address - Phone:888-789-9636
Practice Address - Fax:888-909-6855
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA430393163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health