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NPI Code Detail

MEDICARE: MS. CAROL W SIMMONS RN,FNP,APN

MEDICARE: MS. CAROL W SIMMONS RN,FNP,APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner11782TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003892951
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROL W SIMMONS RN,FNP,APN
Provider Business Mailing Address
First Line : 1509 DULLES DR
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-3718
Country : US
Telephone Number : 337-991-9276
Fax Number :
Provider Business Practice Location Address
First Line : 9155 CRESTWYN HILLS DR
Second Line :
City : MEMPHIS
State : TN
Zip : 38125-8501
Country : US
Telephone Number : 901-261-4848
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2005
Last Update Date : 04/07/2015

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