Chastity Quayondra Sims, NP

Individual provider Active NPI Family Nurse Practitioner · Wesson, MS

NPI 1366987455 · NPPES record last updated Jan 25, 2018

Key facts

NPI
1366987455
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
901702 (MS)
Practice address
2597 Old Highway 51 NE
Wesson, MS 39191-9414
Phone
(601) 754-6545
NPI assigned
Dec 27, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22113TNMDAdult Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 22113 TN
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X 901702 MS Yes

Addresses

Primary practice location

2597 Old Highway 51 NE
Wesson, MS 39191-9414

Mailing address

PO Box 413
Wesson, MS 39191-0413
Phone (601) 754-6545

Other providers in Wesson, MS

All providers in Wesson, MS · Family Nurse Practitioner in Mississippi

Sources for this page

Verify at the official NPI Registry.