Individual
AMANDA MAE SIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1300 RICKEY RD, SHAWNEE, OK 74801-5414
(405) 808-2168
Mailing address
1300 RICKEY RD, SHAWNEE, OK 74801-5414
(405) 808-2168
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0057503
OK
Other
Enumeration date
07/13/2011
Last updated
07/13/2011
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