Provider Demographics
NPI:1629728498
Name:SIMS, MARY ELIZABETH (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:SIMS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:HUNSUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2030 HAMILTON PLACE BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-6038
Mailing Address - Country:US
Mailing Address - Phone:423-553-1823
Mailing Address - Fax:423-553-1829
Practice Address - Street 1:2030 HAMILTON PLACE BLVD STE 220
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6038
Practice Address - Country:US
Practice Address - Phone:423-553-1823
Practice Address - Fax:423-553-1829
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31571363LF0000X
TN219798163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse