Provider Demographics
NPI:1467839274
Name:SIMS, KENDALL (LPN)
Entity Type:Individual
Prefix:MS
First Name:KENDALL
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:PROF
Other - First Name:KENDALL
Other - Middle Name:
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:2844 8TH AVE APT 2C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-2124
Mailing Address - Country:US
Mailing Address - Phone:718-838-1049
Mailing Address - Fax:718-838-1020
Practice Address - Street 1:2844 8TH AVE APT 2C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10039-2124
Practice Address - Country:US
Practice Address - Phone:718-838-1049
Practice Address - Fax:718-838-1020
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299836164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse