Individual
DONTAVIS SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-C
Contact information
Practice address
101 KATHRYN PL, CENTERVILLE, GA 31028-1475
(386) 855-5584
Mailing address
101 KATHRYN PL, CENTERVILLE, GA 31028-1475
(386) 855-5584
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN315090
GA
Other
Enumeration date
04/13/2026
Last updated
04/13/2026
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