Individual
STEPHANIE ANN SIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 TANGLEWOOD DR, REXBURG, ID 83440-4915
(219) 477-9705
Mailing address
611 TANGLEWOOD DR, REXBURG, ID 83440-4915
(219) 477-9705
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
57122
ID
163W00000X
Registered Nurse
95061173
CA
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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