Provider Demographics
NPI:1588392500
Name:SIMS, CAROL JEAN
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JEAN
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20544 US HIGHWAY 23 LOT 15
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-9017
Mailing Address - Country:US
Mailing Address - Phone:740-649-8833
Mailing Address - Fax:
Practice Address - Street 1:20544 US HIGHWAY 23 LOT 15
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-9017
Practice Address - Country:US
Practice Address - Phone:740-649-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant