Healthcare Provider Details

I. General information

NPI: 1669300638
Provider Name (Legal Business Name): DEE-ANNA SIMMONS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 S RONDO RD
TEXARKANA AR
71854-7059
US

IV. Provider business mailing address

2419 S RONDO RD
TEXARKANA AR
71854-7059
US

V. Phone/Fax

Practice location:
  • Phone: 870-571-6454
  • Fax: 870-571-6454
Mailing address:
  • Phone: 870-571-6454
  • Fax: 870-571-6454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number237044
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: