Healthcare Provider Details

I. General information

NPI: 1689066458
Provider Name (Legal Business Name): CHRISTINE M SIMMS MSN, APRN, BC OR CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2015
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 E. FRONT ST
MEDIA PA
19063-2936
US

IV. Provider business mailing address

36 E. FRONT ST
MEDIA PA
19063-2936
US

V. Phone/Fax

Practice location:
  • Phone: 610-892-3802
  • Fax: 610-892-2774
Mailing address:
  • Phone: 610-892-3802
  • Fax: 610-892-2774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number0183860CCNS
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN108603L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: