Individual
DEBRA SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 776-8912
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 776-8912
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2113S
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000294146
ANTHEM
KY
05
—
78009982
—
KY
Enumeration date
06/27/2005
Last updated
07/08/2007
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