Provider Demographics
NPI:1124297080
Name:SIMS, ANICETA A (LMT)
Entity type:Individual
Prefix:MISS
First Name:ANICETA
Middle Name:A
Last Name:SIMS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 ALA MOANA BLVD APT H202
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1360
Mailing Address - Country:US
Mailing Address - Phone:808-371-9041
Mailing Address - Fax:
Practice Address - Street 1:1720 ALA MOANA BLVD APT H202
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1360
Practice Address - Country:US
Practice Address - Phone:808-371-9041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI6101171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI6101OtherLMT