MEDICARE: BRENDA MICHELLE SIMMONS NP

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	363L00000X	Nurse Practitioner	12987	TN
2	363LF0000X	Family Nurse Practitioner	824031	NV

General Provider Information

NPI Number	:	1285814954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA MICHELLE SIMMONS NP

Provider Business Mailing Address
First Line	:	3952 JEMEZ PUEBLO AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-0562
Country	:	US
Telephone Number	:	615-473-6135
Fax Number	:

Provider Business Practice Location Address
First Line	:	3320 N BUFFALO DR STE 106
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7410
Country	:	US
Telephone Number	:	28-696-1907
Fax Number	:	702-869-6199

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

Provider Enumeration Date	:	11/09/2007
Last Update Date	:	04/16/2025

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Directions to “ BRENDA MICHELLE SIMMONS NP” Practice Location

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