Davis Sims, Shannon

Davis Sims, Shannon is an sole proprietor health care provider with primary practice located at 415 S 28Th Ave , Hattiesburg MS 39401-7246. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Davis Sims, Shannon can be contacted via phone (601) 261-3606.

Contact Information

Primary practice address
415 S 28Th Ave Hattiesburg MS 39401-7246
Phone: (601) 261-3606
Fax: (601) 579-5383
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Critical Care Medicine 163WC0200X R878918 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R878918 Mississippi

Profile Details

NPI number 1780022509
LBN Legal business name Davis Sims, Shannon
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2013
Last updated Aug 10th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780022509 NPPES
Mississippi MEDICAID 03170058

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