Provider Demographics
NPI:1407071293
Name:SIMMONS, CHRISTOPHER LYNN (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LYNN
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 PRESTON CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-6358
Mailing Address - Country:US
Mailing Address - Phone:903-870-0910
Mailing Address - Fax:
Practice Address - Street 1:102 MEMORIAL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-2025
Practice Address - Country:US
Practice Address - Phone:903-463-5057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX661011163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice