| NPI | 1104203827 | 
|---|---|
| Former Name | JEQUIE BREANNA SIMS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 24297)  | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 5007620)  | 
| Enumeration Date | 2015-05-01 | 
| Last Update Date | 2018-11-20 |