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Individual

SANDRA K SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
3232 N NORTHHILLS BLVD, FAYETTEVILLE, AR 72703-4005
(479) 587-1700
Mailing address
3232 N NORTHHILLS BLVD, FAYETTEVILLE, AR 72703-4005
(479) 587-1700

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
45271
KS
363LA2200X
Adult Health Nurse Practitioner
Primary
A004848
AR
363LA2200X
Adult Health Nurse Practitioner
R0091687
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1851363469
MO
05
200223030A
OK
05
221903758
AR
Enumeration date
02/07/2006
Last updated
03/30/2020
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