Provider Demographics
NPI:1568776458
Name:SIMS, NATHAN WILLIAM (PA-C)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:WILLIAM
Last Name:SIMS
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PSC 477
Mailing Address - Street 2:BOX 2
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96306-1602
Mailing Address - Country:US
Mailing Address - Phone:0809-773-2867
Mailing Address - Fax:
Practice Address - Street 1:PSC 477
Practice Address - Street 2:BOX 2
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96306-1602
Practice Address - Country:US
Practice Address - Phone:0809-773-2867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant