Provider Demographics
NPI:1528358934
Name:SIMS, VICKIE (MPA)
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W MUSSER ST
Mailing Address - Street 2:APT 2
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-5007
Mailing Address - Country:US
Mailing Address - Phone:775-303-9314
Mailing Address - Fax:775-267-9420
Practice Address - Street 1:600 W MUSSER ST
Practice Address - Street 2:APT 2
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-5007
Practice Address - Country:US
Practice Address - Phone:775-303-9314
Practice Address - Fax:775-267-9420
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner