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General NPI Number Information
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NPI Number | 1649176058
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Entity Type | Organization
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Legal Business Name | CRYSTAL SIMMONS, NURSE PRACTITIONER IN PSYCHIATRY PLLC
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Dates
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Enumeration Date | 10/14/2026
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Last Update Date | 10/14/2026
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Provider Practice Location Address
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Address Line | 2924 COUNTY ROUTE 17 STE 2
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City | DE KALB JUNCTION
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State | NY
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Zip | 13630-3136
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Country | US
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Telephone | 315-244-8600
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Fax | 800-536-4237
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Provider Business Mailing Address
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Address Line | 360 ORE BED RD
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City | DE KALB JUNCTION
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State | NY
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Zip | 13630-3209
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Country | US
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Telephone | 315-244-8600
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Fax | 800-536-4237
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Authorized Official
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Title or Position | OWNER, PROVIDER
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Name | CRYSTAL L SIMMONS
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Credential | PMHNP
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Telephone | 315-244-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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