Provider Demographics
NPI:1407154032
Name:SIMS, DEBRA JOANNE
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:JOANNE
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JOANNE
Other - Middle Name:DORMAN
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:1457 GOLD MINE BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:MARBURY
Mailing Address - State:AL
Mailing Address - Zip Code:36051-3713
Mailing Address - Country:US
Mailing Address - Phone:334-569-1059
Mailing Address - Fax:
Practice Address - Street 1:3741 HIGHWAY 14
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:AL
Practice Address - Zip Code:36054-1905
Practice Address - Country:US
Practice Address - Phone:334-285-6648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist