MEDICARE: REBEKAH WASHINGTON SIMMONS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	191023	GA
2	363LF0000X	Family Nurse Practitioner	1-175965	AL

General Provider Information

NPI Number	:	1811408818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH WASHINGTON SIMMONS APRN

Provider Business Mailing Address
First Line	:	1810 STADIUM DR STE 100
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-3178
Country	:	US
Telephone Number	:	334-281-8303
Fax Number	:

Provider Business Practice Location Address
First Line	:	1810 STADIUM DR STE 240
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-3179
Country	:	US
Telephone Number	:	334-291-8303
Fax Number	:	334-291-8325

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2017
Last Update Date	:	10/09/2025

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