Provider Demographics
NPI:1700223682
Name:SIMS, KERRI DIANNA
Entity Type:Individual
Prefix:MS
First Name:KERRI
Middle Name:DIANNA
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 N OSAGE DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106-6903
Mailing Address - Country:US
Mailing Address - Phone:918-794-0203
Mailing Address - Fax:
Practice Address - Street 1:734 N OSAGE DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-6903
Practice Address - Country:US
Practice Address - Phone:918-794-0203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator