Healthcare Provider Details

I. General information

NPI: 1215864830
Provider Name (Legal Business Name): DEBORAH KAVIRA SIMMONS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 560 BOX 297
APO AP
96376-0003
US

IV. Provider business mailing address

PSC 560 BOX 297
APO AP
96376-0003
US

V. Phone/Fax

Practice location:
  • Phone: 931-305-8802
  • Fax:
Mailing address:
  • Phone: 931-305-8802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: