MEDICARE: SAMANTHA SIMMS

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	101Y00000X	Counselor	P1323	MS

General Provider Information

NPI Number	:	1871444034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA SIMMS

Provider Business Mailing Address
First Line	:	250 BEAUVOIR RD STE 3
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39531-4026
Country	:	US
Telephone Number	:	228-388-2900
Fax Number	:	228-388-2060

Provider Business Practice Location Address
First Line	:	250 BEAUVOIR RD STE 3
Second Line	:
City	:	BILOXI
State	:	MS
Zip	:	39531-4026
Country	:	US
Telephone Number	:	228-388-2900
Fax Number	:	228-388-2060

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

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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Practice Location Address:

250 BEAUVOIR RD # B , SUITE 5
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1518161322 — KERRY LANCE HESSELRODE NURSE PRACTITIONER
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1033437587 — MRS. TARA L SYKES FNP
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1023314416 — JENNIFER LYNN CHATMAN MALLEY NP
Practice Location Address:

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Directions to “ SAMANTHA SIMMS ” Practice Location

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