Provider Demographics
NPI:1770968984
Name:SIMS, JONI LYNN (CNP)
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:LYNN
Last Name:SIMS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JONI
Other - Middle Name:LYNN
Other - Last Name:BURATTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:8423 MARKET ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6778
Mailing Address - Country:US
Mailing Address - Phone:330-729-3190
Mailing Address - Fax:330-729-8701
Practice Address - Street 1:8423 MARKET ST STE 101
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512
Practice Address - Country:US
Practice Address - Phone:330-729-3190
Practice Address - Fax:330-729-8701
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA17822NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0140762Medicaid
OHH410940Medicare UPIN