Provider Demographics
NPI:1275862823
Name:SIMS, SHARON LOUISE (CPNP, PHD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LOUISE
Last Name:SIMS
Suffix:
Gender:F
Credentials:CPNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13050 PARKSIDE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-4275
Mailing Address - Country:US
Mailing Address - Phone:317-621-9000
Mailing Address - Fax:317-621-9194
Practice Address - Street 1:13050 PARKSIDE DR STE 150
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-4275
Practice Address - Country:US
Practice Address - Phone:317-621-9000
Practice Address - Fax:317-621-9194
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28111128A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics