Provider Demographics
NPI:1205832920
Name:SIMS, JAN ALLISON (FNP)
Entity Type:Individual
Prefix:MS
First Name:JAN
Middle Name:ALLISON
Last Name:SIMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 US HIGHWAY 51 BYP E
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-2127
Mailing Address - Country:US
Mailing Address - Phone:731-286-1900
Mailing Address - Fax:731-286-1939
Practice Address - Street 1:1445 US HIGHWAY 51 BYP E
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-2127
Practice Address - Country:US
Practice Address - Phone:731-286-1900
Practice Address - Fax:731-286-1939
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2014-10-07
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-04-27
Provider Licenses
StateLicense IDTaxonomies
TNAPN5639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3904398Medicaid
TN3380640OtherGROUP MEDICAID
TN3380640OtherGROUP MEDICARE
TN3380640OtherGROUP MEDICAID