Provider Demographics
NPI:1689223695
Name:SIMS, ALYSSA (RN)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 N STATE HIGHWAY 360 STE 350
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-1451
Mailing Address - Country:US
Mailing Address - Phone:682-888-1290
Mailing Address - Fax:940-312-7805
Practice Address - Street 1:2080 N STATE HIGHWAY 360 STE 350
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-1451
Practice Address - Country:US
Practice Address - Phone:682-888-1290
Practice Address - Fax:940-312-7805
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX896317163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse