Individual
MRS. LISA SIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
203 MEDICAL BLVD, STOCKBRIDGE, GA 30281-7218
(770) 892-0273
(470) 878-1495
Mailing address
203 MEDICAL BLVD, STOCKBRIDGE, GA 30281-7218
(770) 892-0273
(470) 878-1495
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN1155250
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003144411A
—
GA
05
—
003144411B
—
GA
Enumeration date
05/04/2007
Last updated
10/14/2015
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