Provider Demographics
NPI:1376796144
Name:SIMS, CAROL A (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:A
Last Name:SIMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 GOVERNOR TER
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-2840
Mailing Address - Country:US
Mailing Address - Phone:585-224-0386
Mailing Address - Fax:585-224-8007
Practice Address - Street 1:114 GOVERNOR TER
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-2840
Practice Address - Country:US
Practice Address - Phone:585-224-0386
Practice Address - Fax:585-224-8007
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1946721163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse