Provider Demographics
NPI:1093220071
Name:ABDULLAH-SIMMONS, STEPHANIE (CD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ABDULLAH-SIMMONS
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 GA ZUMP DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-9723
Mailing Address - Country:US
Mailing Address - Phone:407-782-5222
Mailing Address - Fax:
Practice Address - Street 1:921 N FLOOD AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-7641
Practice Address - Country:US
Practice Address - Phone:407-782-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula