Provider Demographics
NPI:1164316998
Name:SIMS, ANDREW TYLER (NP)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:TYLER
Last Name:SIMS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 DRINKARD CT
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN INN
Mailing Address - State:SC
Mailing Address - Zip Code:29644-9778
Mailing Address - Country:US
Mailing Address - Phone:864-270-7136
Mailing Address - Fax:
Practice Address - Street 1:3 DRINKARD CT
Practice Address - Street 2:
Practice Address - City:FOUNTAIN INN
Practice Address - State:SC
Practice Address - Zip Code:29644-9778
Practice Address - Country:US
Practice Address - Phone:864-270-7136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30476363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC30476OtherSTATE APRN LICENSE