Basic Information
Provider Information
NPI: 1003147604
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SIMS
FirstName: JANET
MiddleName: JONES
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9040 JACKSON AVE
Address2:  
City: TACOMA
State: WA
PostalCode: 984310001
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: MADIGAN ARMY MEDICAL CTR
Address2: 9040 REID ST., ATTN: MCHJ-QCR
City: TACOMA
State: WA
PostalCode: 984311100
CountryCode: US
TelephoneNumber: 2539682252
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/20/2010
LastUpdateDate: 05/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X082750TNN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
367500000X14739TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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