Provider Demographics
NPI:1730677675
Name:SIMS, SHEA THOMAS (APRN)
Entity type:Individual
Prefix:MR
First Name:SHEA
Middle Name:THOMAS
Last Name:SIMS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-472-5343
Mailing Address - Fax:870-301-2092
Practice Address - Street 1:1530 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-1515
Practice Address - Country:US
Practice Address - Phone:870-802-3586
Practice Address - Fax:870-802-2037
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005626363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily