Provider Demographics
NPI:1164897880
Name:SIMS, JANET (BSN RN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8291 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MI
Mailing Address - Zip Code:48175
Mailing Address - Country:US
Mailing Address - Phone:972-834-8325
Mailing Address - Fax:
Practice Address - Street 1:8291 FREDERICK ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MI
Practice Address - Zip Code:48175
Practice Address - Country:US
Practice Address - Phone:972-834-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704178178163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator