Provider Demographics
NPI:1649862764
Name:SIMS, MICHELLE RENEA (RN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEA
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 1:7125 BRANDY RUN DR APT 210
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-3675
Mailing Address - Country:US
Mailing Address - Phone:276-358-2259
Mailing Address - Fax:
Practice Address - Street 1:7125 BRANDY RUN DR APT 210
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3675
Practice Address - Country:US
Practice Address - Phone:276-358-2259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001294445163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine