Individual
KATIE P SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1926 23RD AVE, MERIDIAN, MS 39301-3107
(601) 485-1131
Mailing address
PO BOX 20452, YPS-CREDENTIALING, COLUMBUS, OH 43220-0452
(614) 442-2406
(614) 442-2410
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R873386
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09952502
—
MS
Enumeration date
07/12/2010
Last updated
01/05/2015
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