Individual
MRS. SHANNON DAVIS SIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-3606
(601) 579-5383
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-3606
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R878918
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
R878918
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03170058
—
MS
Enumeration date
06/14/2013
Last updated
08/10/2020
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