Basic Information
Provider Information
NPI: 1174912299
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SIMS
FirstName: DAWN
MiddleName: MARIE
NamePrefix: MRS.
NameSuffix:  
Credential: PMHNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 341 E PARKWOOD AVE
Address2:  
City: FRIENDSWOOD
State: TX
PostalCode: 775465147
CountryCode: US
TelephoneNumber: 2819933733
FaxNumber: 2816482200
Practice Location
Address1: 308 S FRIENDSWOOD DR
Address2:  
City: FRIENDSWOOD
State: TX
PostalCode: 775463988
CountryCode: US
TelephoneNumber: 2819933733
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/13/2015
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808X125045TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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