Healthcare Provider Details

I. General information

NPI: 1023006582
Provider Name (Legal Business Name): ALAN D SIMMS CRNA BS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 KENNERLY RD ST ANTHONYS HOSPITAL
ST LOUIS MO
63128-1659
US

IV. Provider business mailing address

16431 SUNDANCE CREEK CT
WILDWOOD MO
63005-7021
US

V. Phone/Fax

Practice location:
  • Phone: 314-895-3828
  • Fax: 314-985-3827
Mailing address:
  • Phone: 636-394-1893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number035653
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number069345
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: