Provider Demographics
NPI:1669913273
Name:SIMS, AUTUMN (QMHS)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:
Other - Last Name:FEATHEROFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 MESSIMER DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1874
Mailing Address - Country:US
Mailing Address - Phone:740-485-1759
Mailing Address - Fax:740-522-2941
Practice Address - Street 1:65 MESSIMER DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1874
Practice Address - Country:US
Practice Address - Phone:740-485-1759
Practice Address - Fax:740-522-2941
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator