Provider Demographics
NPI:1043685373
Name:SIMMONS, TIHESHA E (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:TIHESHA
Middle Name:E
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 503
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20875-0503
Mailing Address - Country:US
Mailing Address - Phone:240-418-9720
Mailing Address - Fax:301-972-2571
Practice Address - Street 1:21345 VILLAGE GREEN CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-6961
Practice Address - Country:US
Practice Address - Phone:240-418-9720
Practice Address - Fax:301-972-2571
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR191196163WC1600X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WH0200XNursing Service ProvidersRegistered NurseHome Health