Provider Demographics
NPI:1134162175
Name:SIMS, JENNIFER A (ANP-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:SIMS
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 ST MARYS EPWORTH XING # B100
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-9497
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 ST MARYS EPWORTH XING # B100
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-9497
Practice Address - Country:US
Practice Address - Phone:812-469-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000358A363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200358600Medicaid
IN000000548365OtherANTHEM PIN ORTHOPAIDICS
IN200358600Medicaid
847950WMedicare PIN