Healthcare Provider Details

I. General information

NPI: 1528384252
Provider Name (Legal Business Name): KATHRYN A SIMMONS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 06/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 REGIONAL PLZ SUITE 1675
ABILENE TX
79606-5250
US

IV. Provider business mailing address

6200 REGIONAL PLZ SUITE 1675
ABILENE TX
79606-5250
US

V. Phone/Fax

Practice location:
  • Phone: 325-795-2100
  • Fax: 325-795-2113
Mailing address:
  • Phone: 325-795-2100
  • Fax: 325-795-2113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number706448
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: