Provider Demographics
NPI:1720750904
Name:SIMS, DONNETTA (TRANSPORTION)
Entity Type:Individual
Prefix:MRS
First Name:DONNETTA
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:TRANSPORTION
Other - Prefix:MRS
Other - First Name:DONNETTA
Other - Middle Name:
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:TRANSPORTION
Mailing Address - Street 1:11001 ASHBURY AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1311
Mailing Address - Country:US
Mailing Address - Phone:216-851-6904
Mailing Address - Fax:
Practice Address - Street 1:11001 ASHBURY AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1311
Practice Address - Country:US
Practice Address - Phone:216-851-6904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)