Provider Demographics
NPI:1467479063
Name:SIMMONS, HEATHER (MSN, FNP, APRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MSN, FNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1478 JORDAN HILLS CT
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-2368
Mailing Address - Country:US
Mailing Address - Phone:727-461-3896
Mailing Address - Fax:727-443-4085
Practice Address - Street 1:1478 JORDAN HILLS CT
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-2368
Practice Address - Country:US
Practice Address - Phone:727-461-3896
Practice Address - Fax:727-443-4085
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001180564207P00000X
TX104345363L00000X
DCRN967019363L00000X
FLAPRN3378572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P91939Medicare UPIN
VAVAA101424Medicare PIN
TX8J4336Medicare PIN