Provider Demographics
NPI:1407586845
Name:SIMS, DESTINYEE YORLE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:DESTINYEE
Middle Name:YORLE
Last Name:SIMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 100109
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0109
Mailing Address - Country:US
Mailing Address - Phone:352-265-0535
Mailing Address - Fax:352-627-4173
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-1458
Practice Address - Country:US
Practice Address - Phone:352-265-0535
Practice Address - Fax:352-627-4173
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9118381363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant