Provider Demographics
NPI:1558786541
Name:SIMS, STEPHANIE RENEE (ARNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:RENEE
Last Name:SIMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:RENEE
Other - Last Name:CERNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 S MOPAC EXPRESSWAY
Mailing Address - Street 2:BUILDING II SUITE 130
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5776
Mailing Address - Country:US
Mailing Address - Phone:512-524-2042
Mailing Address - Fax:
Practice Address - Street 1:701 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5403
Practice Address - Country:US
Practice Address - Phone:405-232-8003
Practice Address - Fax:405-232-8008
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0071680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily