Provider Demographics
NPI:1134443484
Name:SIMS, HOLLY JO (ARNP)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:JO
Last Name:SIMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-1917
Mailing Address - Country:US
Mailing Address - Phone:850-482-0017
Mailing Address - Fax:850-482-6617
Practice Address - Street 1:4295 3RD AVE
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-2120
Practice Address - Country:US
Practice Address - Phone:850-482-0017
Practice Address - Fax:850-526-5002
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9186215363LF0000X
FLAPRN9186215363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily