Provider Demographics
NPI:1073563391
Name:SIMS, KRISTIN ENGLAND (PT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ENGLAND
Last Name:SIMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:L
Other - Last Name:ENGLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2222 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-7958
Mailing Address - Country:US
Mailing Address - Phone:800-944-9782
Mailing Address - Fax:610-438-2046
Practice Address - Street 1:1004 HARDIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-1609
Practice Address - Country:US
Practice Address - Phone:803-283-0987
Practice Address - Fax:803-283-0987
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ33161Medicare UPIN