Provider Demographics
NPI:1235817396
Name:SIMS, MARLA
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:SIMS
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 1:163 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1550
Mailing Address - Country:US
Mailing Address - Phone:614-384-1463
Mailing Address - Fax:
Practice Address - Street 1:163 N 20TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1550
Practice Address - Country:US
Practice Address - Phone:614-384-1463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251F00000X, 374U00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty