Provider Demographics
NPI:1275168171
Name:SIMEO, BAKHITA JOSEPHINE
Entity Type:Individual
Prefix:
First Name:BAKHITA
Middle Name:JOSEPHINE
Last Name:SIMEO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-2613
Mailing Address - Country:US
Mailing Address - Phone:515-639-1166
Mailing Address - Fax:
Practice Address - Street 1:2305 SUMMIT DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-2613
Practice Address - Country:US
Practice Address - Phone:515-639-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX986111163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse