Provider Demographics
NPI:1467935668
Name:SIMS, TESHA L
Entity Type:Individual
Prefix:
First Name:TESHA
Middle Name:L
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6448 CREEKSHORE LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-5078
Mailing Address - Country:US
Mailing Address - Phone:317-597-3637
Mailing Address - Fax:
Practice Address - Street 1:6448 CREEKSHORE LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-5078
Practice Address - Country:US
Practice Address - Phone:317-597-3637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)