Provider Demographics
NPI:1508266164
Name:SIMMS-MACLEOD, JODIE (CNM)
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:SIMMS-MACLEOD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:
Other - Last Name:SIMMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:PO BOX 440420
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0420
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6198
Practice Address - Street 1:1928 ALCOA HWY STE 300
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-305-9799
Practice Address - Fax:865-305-9752
Is Sole Proprietor?:No
Enumeration Date:2014-09-01
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19060367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife