Provider Demographics
NPI:1306391685
Name:SIMS, JILL M (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:M
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 1:13466 WILLOW FIELD DR
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VA
Mailing Address - Zip Code:23192-3064
Mailing Address - Country:US
Mailing Address - Phone:804-883-5255
Mailing Address - Fax:
Practice Address - Street 1:13466 WILLOW FIELD DR
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VA
Practice Address - Zip Code:23192-3064
Practice Address - Country:US
Practice Address - Phone:804-883-5255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001182575163WC0200X
VA2016007836363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine