Provider Demographics
NPI:1215221403
Name:SIMS, AMANDA LEIGH (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LEIGH
Last Name:SIMS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:LEIGH
Other - Last Name:MAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:25145 DEMOTT DR
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64801-6370
Mailing Address - Country:US
Mailing Address - Phone:417-208-0118
Mailing Address - Fax:417-208-0115
Practice Address - Street 1:25145 DEMOTT DR
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64801-6370
Practice Address - Country:US
Practice Address - Phone:417-208-0118
Practice Address - Fax:417-208-0115
Is Sole Proprietor?:No
Enumeration Date:2011-06-05
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011032862183500000X
KS1-109775183500000X
OK19836183500000X
WI16163040183500000X
IA21303183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist