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Individual

MS. ANDREA M SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN/APN

Contact information

Practice address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Mailing address
262 DANNY THOMAS PL, MS 515, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
77749
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
6281
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05683027
MS
05
158288758
AR
05
1721522
LA
05
200071090A
OK
05
427573902
MO
05
5440669
TN
Enumeration date
06/15/2006
Last updated
10/02/2012
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