Provider Demographics
NPI:1093285553
Name:SIMS-STRAUT, KRISTIE LYNN
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:LYNN
Last Name:SIMS-STRAUT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 OLD BRIMSTONE RD
Mailing Address - Street 2:
Mailing Address - City:HELENWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37755-5432
Mailing Address - Country:US
Mailing Address - Phone:423-223-6436
Mailing Address - Fax:423-663-8980
Practice Address - Street 1:378 OLD BRIMSTONE RD
Practice Address - Street 2:
Practice Address - City:HELENWOOD
Practice Address - State:TN
Practice Address - Zip Code:37755-5432
Practice Address - Country:US
Practice Address - Phone:423-223-6436
Practice Address - Fax:423-663-8980
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000111501163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management