MEDICARE: DEBRECCA DENAE SIMMS RN

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
1	163W00000X	Registered Nurse	28300562A	IN

General Provider Information

NPI Number	:	1235086570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRECCA DENAE SIMMS RN

Provider Business Mailing Address
First Line	:	6447 PAW PAW CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-6183
Country	:	US
Telephone Number	:	317-487-9748
Fax Number	:

Provider Business Practice Location Address
First Line	:	6447 PAW PAW CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-6183
Country	:	US
Telephone Number	:	317-487-9748
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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